Effect of multiple sclerosis on income

Typically, people focus on how severe diseases affect their health.  Clearly, however, poor health also can affect people’s income as well as some disease makes holding a job difficult or impossible.  Even people in good health with serious diseases may lower income if they need to miss work frequently for frequent doctor’s appointments. In fact,…

The Status of Outcomes-Based Contracts

Outcomes-based contracts are supposed to be the next big thing.  When payers are not sure about the real-world benefits or cost of a treatment, outcomes-based contracts and help them diversity risk. For instance, CMS will only pay for the CAR-T product  Kymriah when “…these patients respond to Kymriah by the end of the first month…

At ISPOR: The effect of RA medication choice on costs

For those who are attending the International Society For Pharmacoeconomics and Outcomes Research (ISPOR) conference this next week in Baltimore, please check out my poster titled: THE EFFECT OF MEDICATION CHOICE AFTER TUMOR NECROSIS FACTOR INHIBITOR (TNFI) USE ON THE HEALTHCARE COSTS FOR PATIENTS WITH RHEUMATOID ARTHRITIS: AN INSTRUMENTAL VARIABLES APPROACH My co-authors are Ahva…

My take on American Patients First

In broad strokes, the American Patients First plan aims to lower list prices, lower patients’ out-of-pocket costs while maintaining incentives for innovation.   In short, this is a sensible strategy, although there are some concerns about how more restrictive formulary designs could restrict consumer choice. American Patients First in brief To maintain manufacturers incentives to innovate,…

Why hasn’t public value reporting led to more patients choosing high value care?

CMS has a number of quality initiatives to measure provider quality.  For instance, there is the Hospital  Inpatient Quality Reporting Program, the Home Health Quality Reporting Requirements, the Skilled Nursing Facility (SNF) Quality Reporting Program, the Inpatient Rehabilitation Facilities (IRF) Quality Reporting Program (QRP), among others.  Have these initiatives led to more patients choosing high value care? …