Unbiased Analysis of Today's Healthcare Issues
Should health technology assessment (HTA) processes consider using distributional cost effectiveness analysis (DCEA) to incorporate technology impacts on inequality? Some say ‘yes’ and some say ‘no’. Let’s take a look at both sides. No In a Letter to the Editor in Value in Health, Sreeram Ramagopalan noted that NICE currently has a number of concerns…
Many policymakers aim to reduce health disparities across groups. In fact, the distributional cost effectiveness analysis (DCEA) approach aims to incorporate treatment value based on the extent to which they reduce inequality. However, what types of inequality are we trying to reduce: ex-post or ex-ante? Ex post inequality means reducing inequality of outcomes at a…
Catastrophic healthcare expenditures (CHE) are highly problematic for families are are unequally distributed throughout society. However, how can we quantify the incidence, intensity and inequality of CHE in a society? A paper by Ogwang and Mwabu (2025) provide one methodology by using the Watts poverty measure and adapting it to measure CHE. We first describe…
A paper by Ng, Zhang and Kowal (2025) use the American Community Survey (ACS) data from 2016–2022 were used to construct Social Vulnerability Index (SVI). SVI is calculated from 16 social determinants of health (SDoH) variables that are grouped into 4 themes: socioeconomic status, household characteristics, racial and ethnic minority status, and housing type &…
According to the World Health Organization, “Three distinguishing features, when combined, turn mere variations or differences in health into a social inequity in health. They are systematic, socially produced (and therefore modifiable) and unfair. That is how an ISPOR Special Interest Group Report by Griffiths et al. (2025) begins. The health equity primer provides and…
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…
Recently, the Office of Management and Budget has released new procedures to assess government regulation (Circular A-4) and economic policies (Circular A-94). What is unique about this guidance is that it weights benefits and costs of new regulations and policies based on the income of the individuals impacted. The goal is to help reduce inequality.…
Are wealthier people healthier? If so, how strong is this relationship? Does it vary across countries? That is what a paper by Kyriopoulos et al. 2024 aims to answer. They measure health and wealth using a “concentration index” (CI) which is calculated as follows: CI is estimated with reference to the concentration curve, which illustrates…
Interesting paper by Cabral and Dillender (2024). The randomization of gender assignment occurs since the Texas workers compensation insurance relies on random assignment of doctors to patients through their dispute resolution process. The abstract is below: Little is known about what drives gender disparities in health care and related social insurance benefits. Using data and…
A paper by Gupta and Akinyemiju (2024) uses SEER data to examine trends in age-adjusted cancer mortality between blacks and whites between 2000 and 2020. The authors find that: In 2000, the [age-adjusted mortality] rate was 251.7 per 100 000 population among Black individuals and 199.7 per 100 000 population among White individuals, decreasing to 166.8 per…