Unbiased Analysis of Today's Healthcare Issues
Aaron Carroll argues ‘no’ and–in most but not all cases–I agree with him. Here is the evidence he cites: More health insurance does not reduce emergency department (ED) visits. States that expanded Medicaid eligibility with ACA funding saw an increase in ED visits relative to non-expansion states. In Oregon, individuals who won an eligibility ‘lottery’ to…
A paper by Rothman et al. (2017) explains what goes on at the Washington Health Technology Assessment Program’s (WHTAP), the first state-administered health technology assessment (HTA) program in the U.S.: Over the past 9 years, Washington State has been pursuing an innovative and generally effective program to use evidence-based medicine to determine state health care…
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…
A number of studies have claimed that increased health expenditures may result in no better, or even worse outcomes. For instance, a paper by Fisher et al. (2003) looking at patients with acute myocardial infarction, colorectal cancer, or hip fracture finds that “Quality of care in higher-spending regions was no better on most measures and…
Clinical trials for cancer treatments aim to demonstrate whether one treatment is better than another. What is of most interest to patients, providers and payers, however, is which treatment works best in the real-world, not in a randomized controlled trial. Further, clinical trials often use progression free survival to measure treatment outcomes rather than overall…
Did you ever wonder what is is like having lung cancer? Or narcolepsy? What factors are most important to patients when receiving treatment for these diseases? The FDA is working to collect these answers to help guide their drug approval process. The FDA’s “Voice of the Patient” aims to “…more systematically gather patients’ perspectives…
For those attending the British Society for Rheumatology Annual Meeting in Birmingham, England, I will be giving a podium presentation on Wednesday, April 26 at 12pm BST titled “Economic Burden of Rheumatoid Arthritis is Higher for Anti-Citrullinated Protein Antibody-Positive Patients.” Come by Hall 6 to check it out along with other presentations in the Clinical and…
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…
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…
Cost effectiveness research aims to determine if the benefits of a treatment outweigh the cost. But which benefits should be included? How should we weight improvements in different outcomes? What data and methods need to be used to measure benefits and costs? These are questions that academics typically think of as within the domain of…