Orphan Medical Products

Should health insurers cover orphan drugs?  Although the clear answer appears to be yes, the issue is tricky.  An orphan drug is one which treats a limited number of people.  In Europe, this designation generally applies to patients with a disease with an overall prevalence between 5 and 10,000 individuals. In order to incentivize innovators…

What is the value of a QALY?

Many new treatments deliver significant benefits to patients.  In many cases, however, the new treatments may be more expensive.  How do we know if a treatment is worth the cost? Cost effectiveness analysis helps us answer this question.  Cost is fairly easy to calculate but benefits are more complicated.  A treatment could extend a person’s…

Adding the patient perspective to health technology assessment

Health technology assessments (HTAs) aim to measure the cost effectiveness of a given treatment or set of treatments for a specific patient populations.  Often, these assessments are conducted from the point of view of the payer–either a national health system or the individual insurer perspective.  This payer focused perspective can often focus largely on treatment costs rather…

Extended Cost Effectiveness Analysis

Cost effectiveness analysis (CEA) examines whether treatment benefits outweight treatment costs on average for a given patient population. A 2016 paper by Verguet, Kim and Jamison examine the concept of extended cost effectiveness analysis (ECEA) which applies cost effectiveness methodologies to health care policies. The policies are evaluated over 4 domains: (1) health gains; (2)…