Nothing NICE about ICER?

On it’s website, the Instititute for Clinical and Economic Review (ICER) claims that it is “…a trusted non-profit organization that evaluates evidence on the value of medical tests, treatments and delivery system innovations and moves that evidence into action to improve the health care system. ” A recent article in Huffington Post however, disagrees.  They make two key…

Cost effectiveness analysis Q&A

What is cost effectiveness analysis or CEA?   One definition is that CEAs–at least in the field of health care–measure the difference or ratio between cost of care and the benefits of care for a given intervention compared to an alternative treatment strategy.  The intervention could be a new surgical procedure, a drug, a behavior modification program or any other…

What influences NICE decisions?

The National Institute for Health and Care Excellence (NICE) claims that although cost-effectiveness is highly valued in its health technology appraisal process, it sates that there are other factors considered relevant.  However, no explicit weight is assigned to these other factors.  Do they matter? A paper by Dakin et al. (2015) tries to answer this question by looking…

Quality-Adjusted Cost Of Care

One of my paper (along with co-authors Darius Lakdawalla, Claudio Lucarelli, Sean Nicholson, Zeba M. Khan and Tomas J. Philipson) was published at Health Affairs.  The title of the study is: Quality-Adjusted Cost Of Care: A Meaningful Way To Measure Growth In Innovation Cost Versus The Value Of Health Gains.  The abstract is below. Technology drives both…

Extended Cost Effectiveness Analysis

Most people know what cost-effectiveness analysis (CEA), but what is extended cost effectiveness analysis (ECEA)?  A paper by Verguet, Laxminarayan,and Jamison (2014) describes the ECEA approach as it relates to the benefits of universal public finance (UPF) of specific medical treatments.  CEA measures the effectiveness of a treatment relative to its cost.  ECEA does this…

Why does cost effective care spread so slowly

According to Fuchs and Millstein, here’s why: Insurers hesitation to standardize coverage.  Standardization of coverage would force insurance companies to compete primarily on the basis of price, which would put pressure on their profits. Employers bear too much of the marginal cost from employees choosing expensive health plans.  Because companies wish to avoid alienating employees,…

Economics of the Timing of Influenza Vaccine

Although the H1N1 influenza virus has garnered most of the media attention, protecting children against standard strains of influenza has generally been shown to be cost effective.  However, the cost effectiveness depends on the timing.  The flu season generally lasts from September to June, but flu generally has the highest incidence in November and December.…

Does spending improve outcomes?

From a paper by Weinstein and Skinner (NEJM 2010): “Moreover, there is considerable variation in health care expenditures and a weak or even negative association between spending and outcomes, such as mortality at the regional level and quality measures at the state level. This evidence has been interpreted to mean that cutting back on these…