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…

Health Care in Malaysia

Malaysia is a middle income country (GDP per capita $26,600, about half of U.S. income levels) of 30.5 million people (about the population of New York and Ohio combined).  Life expectancy is 74.75 years, just 5 years below the U.S.  Health spending in Mayalsia is only 4% of GDP (compared to 17% of GDP in…

CER Around the World

Both the stimulus bill (i.e., The American Recovery and Reinvestment Act of 2009 [ARRA]) and Obamacare (the Affordable Care Act [ACA]) contain provisions to increase funding for compariative effectiveness research (CER).  According to a Deloitte Issue Brief, ARRA provided the foundation for the ACA’s newly mandated and immediately effective CER entity, the Patient-Centered Outcomes Research Institute…

Pharmaceuticals in Italy

Thomas Schael, ex-commissioner at the Public Health Authority of Naples, led the implementation of a system that produced annual drug expenditure savings of €20m.  How did he do it?  Eye for Pharma has a revealing two–part interview. The first thing Schael did to reduce the cost of pharmaceuticals in Italy was to improve the efficiency…

Health Reform in China

What is health insurance like in China?  A 2011 paper by Zhong in Health Economics provides a nice overview, which I discuss in today’s post. Between the 1950s and the end of the 1970s, three primary insurance schemes covered almost all Chinese citizens. Cooperative Medical System (CMS).  This program existed in 90% of Chinese villages. …

P4P and Diabetes Care

In April 2006, Ontario instituted the Diabetes Management Incentive (DMI) that increased payments to physicians that provided high-quality diabetes care. Did the incentive improve payments quality? According to a paper by Kantarevic and Kralj (2012), it turns out that the answer is yes, but the magnitude of the change depends on the type of physician.…

Healthcare Outsourcing in the UK

Many liberals laud Europe’s government-run health care sectors as a model to emulate.  In particular, Great Britain’s National Health Service (NHS) often is seen as the ideal single payer system.  In reality, however, the British government itself does not supply all services. A study from the Public Services International Research Unit (PSIRU) describes the gradual…

Capitalism and Russia’s Alcohol Problem

It turns out that capitalism was not the cause of Russia’s current (largely alcohol-related) mortality crisis.  From an NBER working paper by Bhattacharya, Gathmann, and Miller (2012): Political and economic transition is often blamed for Russia’s 40% surge in deaths between 1990 and 1994. Highlighting that increases in mortality occurred primarily among alcohol-related causes and…

Hepatitis C Around the World

The global burden of the hepatitis C virus (HCV) is distressing. “[A]n estimated 130–170 million persons (2%–3% of the world’s population) are living with hepatitis C virus (HCV) infection [1]. This infection, particularly in its chronic form, is associated with sizable morbidity and mortality. More than 350 000 deaths are attributed to HCV infection each…