Category: HTA

SHEER: Good practices for incorporating family and caregiver spillovers into health economic evaluations

Jason Shafrin

Illnesses impact not only the patients, but oftentimes impact caregivers and family members as well. However, most economic analyses do not incorporate a diseases’ spillover impacts on caregivers. …a recent review of NICE evaluations revealed that only 3% of technology appraisals included caregiver health-related quality of life (HRQoL) in cost-utility analyses (CUAs). Similarly, Lamsal [2022]…

Valuing treatments for rare disease

Jason Shafrin

That is the topic of a recent white paper from the Innovation and Value Initiative titled “Valuing Rare Disease Treatments in Healthcare: Real Experience, Real Impact“. The report notes a number of challenges in assessing treatment value in rare disease (see my white paper “Challenges in Preserving Access to Orphan Drugs Under an HTA Framework”…

Are We Valuing Prescription Drugs Appropriately?

Jason Shafrin

That is the title of a new Health Affairs Forefront article by Peter Neumann and Joshua Cohen. An excerpt is below: One reason economic analyses may yield estimates that are too low is that they ignore the downstream declines in drug prices that occur when competitors enter the market and especially with the introduction of…

Why you should include dynamic drug pricing in your CEA model

Jason Shafrin

A Health Affairs Forefront paper by researchers Melanie Whittington, Peter Neumann, Joshua Cohen, and Jonathan Campbell makes a compelling case for incorporating drug price dynamics into cost effectiveness analysis. The first questions many people may have is ‘how do drug prices usually change over time?’ A drug’s net price often increases following launch and may…

Trial-Based Economic Evaluations in R

Jason Shafrin

A recent paper by Ben et al. (2023) provides an R tutorial for implementing economic evaluations–often cost effectiveness analyses–using data from clinical trials and analyzed using R. The article starts by providing a summaries of key issues researchers face when conducting these economic evaluations: Missing values. Missing data are common in clinical trials either due…

evLYG Explained

Jason Shafrin

One concern when using quality adjusted life years (QALY) to measure health gains for cost effectiveness research is that QALYs “undervalue” health gains from life extension for people with serious illness or chronic disability. To see this clearly, take a look at the QALY formula (first formula below) and how it can be decomposed into…

The concordance between comparative effectiveness and cost effectiveness

Jason Shafrin

Both the Inflation Reduction Act and Affordable Care Act contained language that made cost-effectiveness analysis difficult to implement, while allowing for the analysis of comparative effectiveness with respect to the relative health benefits across treatments. This leads to the natural question, how often are would reimbursement decisions based on comparative effectiveness alone be the same…