Unbiased Analysis of Today's Healthcare Issues
Let’s say that there is a very severe disease—let’s call it horriblitis—with significant impacts on patient morbidity and mortality. The only available treatment for horriblitis is drug called BlackPill. BlackPill improves health outcomes by 1 QALY over best supportive care (BSC), but costs $500,000 over the patient’s lifetime. While not cost effective by traditional standards,…
Cost effectiveness analyses (CEA) aim to examine how a new health technologies impact health outcomes and costs over a patient’s lifetime. While extrapolating long-run health benefits and measuring potential cost offsets are important, another important item to estimate is how the cost of the new health technology is likely to evolve over times. This is…
That is the title of my article with Jaehong Kim, Shanshan Wang and Slaven Sikirica in the Journal of Comparative Effectiveness Research. The abstract is below. Aim: To assesses the cost–effectiveness of sotagliflozin for the treatment of patients hospitalized with heart failure and comorbid diabetes. Materials & methods: A de novo cost–effectiveness model with a Markov structure was created…
James Chambers has put together a series of papers looking at health gains (and cost effectiveness) using the Tufts Cost Effectiveness Analysis Registry. In these studies , he finds that treatments for rare diseases, specialty drugs, and those that receive expedited review are more likely to provide the largest health benefit (≥0.9 QALYs gained versus…
That is the question asked by Peter Neumann, Madison Silver, and Joshua T. Cohen in their recent Health Affairs blog article. The authors use publicly-available information from ICER reports, in order to analyze committee member votes across 48 treatments assessed by ICER. ICER reports considered were published between December 2014 and August 2018. As shown…
Health technology assessment (HTA) is growing in popularity. Already widely entrenched in Europe, in the U.S. value frameworks are being used to measure the cost effectiveness of different therapies. Some of these frameworks, however, take a narrow view of societal benefits and value to include components of value to patients or society such as caregiver…
Value-based insurance design (VBID) is a simple concept. In short, interventions that provide high-value should be covered with little cost sharing; treatments with low-value should be covered with higher rates of cost sharing or in some cases perhaps not even covered at all. A paper by Cohen et al. (2017) aims to see how far…
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…
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…
High drug prices are in the spotlight. While expensive, many of these treatments improve patients quality of life and even extend patient’s life expectancy. How do you balance treatment cost and benefits? Peter Neumann and Gillian Sanders have a perspective piece in NEJM describing the findings of the Second Panel on Cost-Effectiveness in Health and…