Cost-Effectiveness Analysis 2.0

High drug prices are in the spotlight. While expensive, many of these treatments improve patients quality of life and even extend patient’s life expectancy. How do you balance treatment cost and benefits? Peter Neumann and Gillian Sanders have a perspective piece in NEJM describing the findings of the Second Panel on Cost-Effectiveness in Health and…

Nothing NICE about ICER?

On it’s website, the Instititute for Clinical and Economic Review (ICER) claims that it is “…a trusted non-profit organization that evaluates evidence on the value of medical tests, treatments and delivery system innovations and moves that evidence into action to improve the health care system. ” A recent article in Huffington Post however, disagrees.  They make two key…

Patient perspective on cancer care funding

Improvement in survival (a.k.a. efficiacy) clearly are important, but what other factors matter?  According to a systematic literature review by MacLeod, Harris and Mahal (2016), these factors include: patients favour funding for cancer medicines that improve health outcomes demonstrated by ‘clinical efficacy’ [Oh et al.], ‘prolonged survival’ [Goldman et al., Seabury et al. Lakdawalla et al.] and/or…

Efficacy vs. Effectiveness vs. Efficiency

Efficacy describes the technical relationship between the technology and its effects (whether it actually works), whereas effectiveness concerns the extent to which application of an efficacious technology brings about desired effects (changes in diagnoses, altered management plans, improvement in health)…Efficiency is an economic concept which relates efficacy and effectivness to resource use.  Assessment of efficiency is…

CEA for EBP

How do you implement a cost effectiveness analysis (CEA) for the implementation of evidence-based practices (EBP)?  This is the topic Fortney et al. (2014) address.  They review four types of CEAs. Trial based CEA. Relies on traditional randomized controlled trials (RCT).   Because RCTs are expensive, they are typically run on a small sample of the…

CER Around the World

Both the stimulus bill (i.e., The American Recovery and Reinvestment Act of 2009 [ARRA]) and Obamacare (the Affordable Care Act [ACA]) contain provisions to increase funding for compariative effectiveness research (CER).  According to a Deloitte Issue Brief, ARRA provided the foundation for the ACA’s newly mandated and immediately effective CER entity, the Patient-Centered Outcomes Research Institute…