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…

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…

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…

Hospital of the future

The Economist‘s recent article “Prescription for the future” describes some new trends in health care treatment and predicts what the hospital of the future will look like.  Some excerpts are below: When I think of the hospital of the future, I think of a bunch of people sitting in a room full of screens and phones,”…

What is causing U.S. debt to explode?

According to the Congressional Budget Office’s (CBO’s) 2017 Long-Term Budget Outlook, you need to look no further than entitlements for the elderly. Mandatory programs have accounted for a rising share of the federal government’s noninterest spending over the past few decades, exceeding 60 percent for the past several years. Much of the growth has occurred because…

Does drug detailing affect prescribing patterns?

The obvious answer seems to be ‘yes’.  Why would pharmaceutical companies spend billions of dollars on drug detailing (i.e., visits by pharmaceutical representatives to physicians to explain drug benefits) and drug samples if they don’t work?   When I say billions, I mean billions: A new study by Datta and Dave (2017), however, finds that drug…