Unbiased Analysis of Today's Healthcare Issues
What happens when you have missing data? Many people recommend using multiple imputation (see Briggs et al. 2003; Faria et al. 2014; Gomes et al. 2013; Hunter et al., 2015; Hughes et al., 2016). This approach, however, generally assumes that data are missing at random. Missing at random could be interpreted as the probability that health…
Value frameworks are all the rage of late. But are payers really using them? According to my colleague Jeremy Schafer, the answer is yes. From an article in Drug Topics: “Value assessment may become more important as the health-care market shifts to outcomes and value-based reimbursement models,” said Jeremy Schafer, PharmD, MBA, Senior Vice President…
That is the topic of a Health Affairs blog post published today by James Baumgarder and Peter Neumann. An excerpt is below. Cost-effectiveness analysis (CEA) is an important tool for assessing and pointing the way toward better health care efficiency. The number of published CEAs on health care interventions has blossomed, averaging 34 per year…
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…
Value-based pricing has become all the rage of late among health policy wonks. Medicare aims to tie 90% of reimbursement to some measure of value by 2018. The AMA has endorsed value-based pricing for pharmaceuticals. Organizations such as IVI and ICER propose different approaches for measuring value as well. Typically, value is measured as the…
How do you do cost effectiveness the right way? Peter Neumann–a colleague of mine at Precision Health Economics–edits a book to explain how to do just that. Neumann and Gillian D. Sanders, Louise B. Russell, Joanna E. Siegel, and Theodore G. Ganiats have produced a second edition of their classic text Cost-Effectiveness in Health and Medicine. The…
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…
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 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…
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…