Unbiased Analysis of Today's Healthcare Issues
A paper by Qato et al. (2024) quantifies the degree of of pharmacy benefit manager (PBM) market concentration. Across all payer types, the PBM market was highly concentrated, with an HHI [Herfindahl Hirschman Index (HHI)] of 1972…the HHI was lowest in commercial insurance (1940), with 90 PBM participants, and highest in Medicare Part D (2399),…
A paper by Campbell et al. (2024) provides some guidance. The authors developed a series of recommendations based on literature review, expert interviews and an expert workshop in order to support consistent and transparent evaluation and use of validated family spillover effects in health technology assessments (HTA) and cost-effectiveness analyses (CEA). The expert panel consisted…
The answer to this question, of course, depends on your specific research question. However, it is helpful to review what has been done in previous literature. A paper by Vasileiou et al. (2018) conducted a systematic literature review of all published studies using a single-interview-per-participant designs within three health-related journals: British Medical Journal (BMJ), British…
One of the goals of cost sharing (e.g., copayments, deductibles) is to decrease moral hazard. In other words, if a good is free (or lower cost), you’ll consume more of it than if you had to pay for all of it out-of-pocket. One challenge in health care ours that prices are not transparent. How much…
Health Services Research has decided that studies using logistic regressions should report marginal effects rather than odds ratios. Why did they make this decision? A paper by Norton et al. (2024) identifies 3 key factors. Intelligibility. Consider the case of examining the impact of whether a hospital is in a disadvantaged area on readmission rates.…
The above is the title of a helpful primer from Kenney and Keast (2024). I summarize some key points below. Provide an overview of the pharmacy contracts between stakeholders in the healthcare ecosystem. How did the rise of health maintenance organizations (HMOs) impact pharmacy contracting? The Health Maintenance Organization (HMO) Act of1973 spurred the growth…
A de facto number that is used by National Institute for Health and Care Excellence (NICE) is £30,000 per quality adjusted life year (QALY). Some recent literature (Martin et al. 2023) argues for a lower cost-effectiveness threshold (£15,000/QALY or less) based on their marginal cost per QALY (MCPQ) estimates. Alternatively, a paper by Sampson and…
Perhaps more education is needed. That is the conclusion from a paper by Giovatto et al. (2024). The authors conducted an online survey of US prescribers and health system specialty pharmacists practicing in the rheumatology, dermatology, and gastroenterology. Among the 31 prescribers and 44 pharmacists who responded to the survey: Only 16.0% of prescribers and…
Physician access limitations to those with cold or flu in Spain. Big investments in AlphaFold’s AI. Vaccination tipping point? New CMS legislation on prior authorization. Republican candidates on health care.
Generalized risk-adjusted cost effectiveness (GRACE) aims to incorporate risk preferences into standard cost effectiveness analysis (CEA) methods. While traditional CEA assumes individuals are risk neutral, GRACE allows for risk preferences to influence value. Namely, that health gains in more severely ill health states are valued more than equivalent health gains in better health states. But…