Unbiased Analysis of Today's Healthcare Issues
In the United Kingdom, the National Institute for Health and Care Excellence (NICE) made an update to their health technology evaluations manual in January 2022. Of particular interest, section 6.2 of the manual states that the review committee “will consider the associated absolute and proportional QALY shortfall.” The committee defined QALY shortfall two ways: Absolute…
Standard quality approach compares the difference in QALYs which is a function of survival and quality of life during each survival period. Consider the comparison of treatments A and B, where treatment A is the novel treatment and treatment B is the standard of care. Under the QALY based approach this is calculated as Where…
What is a rare disease? The definition varies across countries, but according to the European Medicines Agency (EMA) rare diseases are those with a prevalence of <5 cases per 10,000 people; ultra-rare diseases are those with <1 case per 50,000 people. In most cases, rare disease must not only be rare but also severe, often…
Standard cost-effectiveness analysis assumes that any gain in quality-adjusted life years (QALYs) should be valued equally. This does not sound unreasonable, but is it true in practice? Consider two potential violations of constant value of QALY gains: scope insensitivity and severity independence. I define each of these below: Scope insensitivity. This assumes that individuals value…
Cost effectiveness analysis aims to capture identify (and monetize) all of a treatments benefits, risk and costs and then determine if the treatment is worth the money. Traditionally, however, benefits, risk and costs only related to benefits that accrue to the health care system. Many studies in the academic literature have advocated for a societal…
The New York Times has a very interesting piece on the caregiver experience. Americans spend so much time debating so many aspects of health care, including insurance and access. Almost none of that covers the actual impossibility and hardship faced by the many millions of friends and family members who are caregivers. It’s hugely disrupting…
To find out the answer to this question, check out a live webinar on Wednesday, March 13th at 1:30pm EDT led by Dr. Anupam Jena, MD, PhD. Dr. Jena is a Harvard Professor and Precision Health Economics Scientific Advisor. In this unique one-hour webinar, Dr. Jena will outline a broader framework for assessing value to improve identification of not…
That is the question of interest of a new study by Snider et al. (2018) in Value in Health. The authors use six reviews by the Institute for Clinical and Economic Review (ICER) that forecast the likely national spend on specific drugs or drug classes as case studies. Their study compares these forecast to subsequent…
That is the question asked by Peter Neumann, Madison Silver, and Joshua T. Cohen in their recent Health Affairs blog article. The authors use publicly-available information from ICER reports, in order to analyze committee member votes across 48 treatments assessed by ICER. ICER reports considered were published between December 2014 and August 2018. As shown…
The Second Panel on Cost Effectiveness in Health and Medicine made a number of recommendations of how to improve cost effectiveness analysis (CEA). Yet, CEA is far from “solved”. In a recent article by Neumann et al. (2018), the Second Panel identifies seven CEA areas where additional research is needed. This include: CEA and perspective:…