Unbiased Analysis of Today's Healthcare Issues

Archive for April, 2017

Presentation at 2017 British Society for Rheumatology

For those attending the British Society for Rheumatology Annual Meeting in Birmingham, England, I will be giving a podium presentation on Wednesday, April 26 at 12pm BST titled “Economic Burden of Rheumatoid Arthritis is Higher for Anti-Citrullinated Protein Antibody-Positive Patients.”  Come by Hall 6 to check it out along with other presentations in the Clinical and […]

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How does payment reform affect providers in competitive vs. non-competitive markets?

How does payment reform affect access to care?  And what does payment reform mean? Payment reform can mean manythings but in this context we will mean substituting fee-for-service or cost-plus reimbursement schemes for fixed reimbursement for a fixed episodes of care or fixed bundles of services during a specific time frame. One example of how payment reform worked, […]

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Who’s on First Health Wonk Review + Links

Brad Wright has posted the  Health Wonk Review: Who’s On First? Edition at Wright on Health.   Check it out along with some other interesting links from the week. Consultants and policymakers. Superbabies. Blocks grants: Case study in Canada. A pact. Standards-based grading. Brand penalty.

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FDA Hedges

Pharmaceutical companies face major risk.  There is risk that the drugs they are researching don’t work (e.g., lack of efficacy) or are not safe.  There is risk that health insurers or government payers will not cover their treatment.  And there is risk that the FDA will not approve a drug after a Phase III clinical trial. […]

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Access to cancer care in the UK

Being sick in the United Kingdom has advantages and disadvantages.  Supporters will cite that out-of-pocket costs are generally low, coverage is universal, and the price of health care to the government is lower. One question is, what is the quality of care received?  Critics cite that access to cutting edge, innovative treatments is often restricted or […]

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How do patients and physicians make good treatment decisions?

The answer seems to be just find the “best” treatment.  In theory this sounds easy, but in practice it is difficult.  What does best mean?  What if one treatment has better outcomes on average but is riskier?  What if one treatment is more effective than another but requires injections rather than pills?  What if patients have […]

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Why aren’t there more cures?

The answer is money, reimbursement, and incentives.  Treating chronic disease gives innovators payoff over a long period of time.  If innovators created a cure for that disease, they could of course charge the net present value of this same stream of payments.  Health plans, patients and the media, however, are often shocked at the high sticker […]

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Applying Cost Effectiveness Analysis to all Health Care Interventions

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 […]

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Orphan Medical Products

Should health insurers cover orphan drugs?  Although the clear answer appears to be yes, the issue is tricky.  An orphan drug is one which treats a limited number of people.  In Europe, this designation generally applies to patients with a disease with an overall prevalence between 5 and 10,000 individuals. In order to incentivize innovators […]

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How to measure preferences in health

Which treatment is the best?  This is a seemingly simple question, but there are many answers.  Some people would say whatever the clinical evidence says.  Others would contend that patient preferences are paramount and patient preferences should rule the day.  In our current world of health care largely paid for by insurance, how should the preferences […]

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