That is the title of my latest Perspectives from the Healthcare Economist article published in The Evidence Base this week. Here is the teaser:
In this guest column, healthcare economist Jason Shafrin (FTI Consulting and Mann School of Pharmacy, University of Southern California) explores a widening divide over how health systems define value, and what that means for drug pricing and innovation. He contrasts two competing visions of value in health technology assessment (HTA): HEMA’s cautious, budget‑constrained approach centered on quality-adjusted life years (QALYs), and generalized cost‑effectiveness analysis (GCEA), which seeks to incorporate broader societal benefits such as risk, equity, and innovation.
The article is in a Q&A format, and aims to answer the following questions:
- Why did HEMA write this report?
- What is generalized cost‑effectiveness analysis?
- Was the HEMA evaluation comprehensive?
- What were HEMA’s recommendations?
- Do HTA bodies have to assume a fixed budget?
- Would use of GCEA increase pharmaceutical spending?
- Why did one of the HEMA’s own authors claim their evaluation was biased?
- Why should anyone outside of health economists care about this debate?
To find the answers, you can read the full article here (registration required, but access is free!).