Unbiased Analysis of Today's Healthcare Issues
Generalized risk-adjusted cost effectiveness analysis (GRACE) abandons the assumption of risk neutrality held by traditional cost effectiveness analysis (TCEA). While this sounds like a very technical issue, by allowing for risk aversion over quality of life, GRACE places a relatively higher value on treatments that improve health for more severe diseases and relatively lower value…
That is the title of my article out today in The Evidence Base. Here is an excerpt: The Centers for Medicare and Medicaid Services (CMS) are now setting drug prices under the Medicare Drug Price Negotiation program. Unlike other health technology assessment (HTA) bodies worldwide, however, CMS will not consider quality-adjusted life years (QALYs) when setting drug…
That is the title of my latest paper in JMCP with co-authors Jaehong Kim, Shanshan Wang, Moises Marin, Slaven Sikirica, and Mariam Anderson. The study abstract is below. BACKGROUND: Patients with type 1 diabetes (T1D) have a greater than 50% lifetime risk of developing comorbid chronic kidney disease (CKD). Glycemic control can reduce diabetes-related complications…
The answer appears to be ‘yes’ according a recent paper written by Uchechukwu Love Anyaduba, Oluwatosin Qawiyy Orababa, Zion Faye, Nazia Rashid, Gregory Reardon and myself. The abstract is below: BackgroundCancer trials increasingly use surrogate endpoints, but it is unclear how well recurrence-free survival (RFS) or disease-free survival (DFS) specifically predict overall survival (OS) in…
That is the question asked in a new paper by Enright, et al. (2025). The authors use the Tufts Medical Center Specialty Drug Evidence and Coverage (SPEC) database current as of August 2023. This database contains publicly available specialty pharmacy coverage decisions as issued by 18 large US commercial health plans, which—collectively—cover 200m people (i.e.,…
Quality-adjusted life years (QALYs) are commonly used to evaluate the impact of new medical technologies on patient mortality and morbidity. However, use of QALYs Many authors have discussed the fact that standard assumptions result in utility functions that are unrealistically linear and separable, overlooking the diminishing marginal utility a fundamental property of utility functions in…
That is the title of a paper from Costa-Font and Vilaplana-Prieto (2025). They find the the value is very large indeed. Relative to a country’s Gross Domestic Product (GDP), the value of IC [informal care] ranges between 4.2% in France and 0.85% in Germany. Such relative value declines as the country’s share of formal LTC…
A paper by Kowal et al. (2023) does in fact measure the disparities in health outcomes. To do this, they use data from the American Community Survey (ACS), the National Vital Statistics System (NVSS) and the CDC’s Social Vulnerability Index (SVI) to estimate differences in life expectancy (LY), quality-adjusted life expectancy (QALE), and disability-free life…
Cost effectiveness analyses (CEA) aim to examine how a new health technologies impact health outcomes and costs over a patient’s lifetime. While extrapolating long-run health benefits and measuring potential cost offsets are important, another important item to estimate is how the cost of the new health technology is likely to evolve over times. This is…
That is the title of my new paper in Annals of the American Thoracic Society with co-authors David Ost, Fabien Maldonado, Jaehong Kim , Moises Marin, Tony Amos, Deanna Hertz, Iftekhar Kalsekar, and Anil Vachani. The abstract is below. Rational: While previous studies have assessed the clinical or economic value of specific technologies, the economic…