Physicians moving to larger groups

This is the finding of Muhlestein and Smith (2016): The proportion of physicians in groups of nine or fewer dropped from 40.1 percent in 2013 to 35.3 percent in 2015, while the proportion of those in groups of one hundred or more increased from 29.6 percent to 35.1 percent during the same time period. Initiatives requiring…

Evaluating Matching-Adjusted Indirect Comparisons in Practice

One of my papers on matching-adjusted indirect comparisons (MAIC) was published today, with co-authors Anshu Shrestha, Amitabh Chandra, M. Haim Erder, and Vanja Sikirica.  The title is: “Evaluating Matching-Adjusted Indirect Comparisons in Practice: A Case Study of Patients with Attention-Deficit/Hyperactivity Disorder” and the abstract is below.  Check it out! Differences in patient characteristics across trials may bias efficacy estimates…

Should patients pay high-cost sharing for treatments for the Hepatitis C Virus?

Treatments for the hepatitis C virus (HCV) are expensive.  At one point they cost over $80,000 per year, although costs have decreased since then.  To prevent moral hazard, should insurance companies rely on cost sharing to decrease utilization?  An article by Lakdawalla, Linthicum, and Vanderpuye-Orgle (2016) argues that they shouldn’t. Cost sharing appears even less efficient when…

Developing new antibiotics is vital

Antibiotics are one of the greatest inventions.  They rank in ABC News’s top 10 health advances of all time.  However, bacteria are not static.  They can change and mutate to become anti-biotic resistant.  In this constant battle against disease, new antibiotics are needed. Harvard’s Mega-Plate Petri Dish experiment shows in vivid detail why the development of…

Is Precision Medicine ready for prime time

According to two researchers, the answer is no.  As they write at Stat: As we wrote recently in Science, three key barriers are impeding the drive toward truly transformational precision medicine: researchers often don’t rigorously test the biological theories that supposedly explain why a targeted treatment should work; they haven’t fully determined the accuracy of the diagnostic…

The problem with step therapy

Step therapy is good in theory, but often not in practice.  In step therapy, patients are required to try one drug first–typically a low cost and/or high-value treatment–before moving on to more expensive alternatives.  In theory, this is a great idea.  The first drug patients should try should be the highest value one. In practice, however,…

Are you going to be working on Labor Day?

According to an article in the American Psychological Association webpage, the answer is likely ‘yes’. Originally intended as a day for relaxation and celebration of the American worker, Labor Day today is very different from the first Labor Day in 1882. Back then, a largely industrial and agricultural workforce could disconnect from work on Labor Day…