Unbiased Analysis of Today's Healthcare Issues

Archive for the 'CER' Category

Do pharmaceuticals have value to healthy people?

Value-based pricing has become all the rage of late among health policy wonks. Medicare aims to tie 90% of reimbursement to some measure of value by 2018. The AMA has endorsed value-based pricing for pharmaceuticals. Organizations such as IVI and ICER propose different approaches for measuring value as well. Typically, value is measured as the […]

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Cost-Effectiveness in Health and Medicine

How do you do cost effectiveness the right way?  Peter Neumann–a colleague of mine at Precision Health Economics–edits a book to explain how to do just that.  Neumann and Gillian D. Sanders, Louise B. Russell, Joanna E. Siegel, and Theodore G. Ganiats have produced a second edition of their classic text Cost-Effectiveness in Health and Medicine.  The […]

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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 […]

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Patient perspective on cancer care funding

Improvement in survival (a.k.a. efficiacy) clearly are important, but what other factors matter?  According to a systematic literature review by MacLeod, Harris and Mahal (2016), these factors include: patients favour funding for cancer medicines that improve health outcomes demonstrated by ‘clinical efficacy’ [Oh et al.], ‘prolonged survival’ [Goldman et al., Seabury et al. Lakdawalla et al.] and/or […]

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Efficacy vs. Effectiveness vs. Efficiency

Efficacy describes the technical relationship between the technology and its effects (whether it actually works), whereas effectiveness concerns the extent to which application of an efficacious technology brings about desired effects (changes in diagnoses, altered management plans, improvement in health)…Efficiency is an economic concept which relates efficacy and effectivness to resource use.  Assessment of efficiency is […]

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CEA for EBP

How do you implement a cost effectiveness analysis (CEA) for the implementation of evidence-based practices (EBP)?  This is the topic Fortney et al. (2014) address.  They review four types of CEAs. Trial based CEA. Relies on traditional randomized controlled trials (RCT).   Because RCTs are expensive, they are typically run on a small sample of the […]

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CER Around the World

Both the stimulus bill (i.e., The American Recovery and Reinvestment Act of 2009 [ARRA]) and Obamacare (the Affordable Care Act [ACA]) contain provisions to increase funding for compariative effectiveness research (CER).  According to a Deloitte Issue Brief, ARRA provided the foundation for the ACA’s newly mandated and immediately effective CER entity, the Patient-Centered Outcomes Research Institute […]

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Use Of Comparative Effectiveness Research By Four European Health Authorities

How do different European health authorities use comparative effectiveness research (CER) to determine drug coverage and pricing?  A recent Health Affairs article by Cohen, Malins and Shahpurwala answer just this question.  Here is a table summarizing the mission and priorities of health authorities in England, France, Germany and the Netherlands.   Source: Joshua Cohen, Ashley […]

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Are minimally invasive surgeries worth the cost?

In the past decades, many surgeries have gone from a standard, open surgical approach to a minimally invasive one using laproscopic, endoscopic, and catheter based techniques.  What has been the effect of these innovations on medical spending and employee absenteeism? To answer this question, a paper by Epstein et al. (2013) examines a sample of […]

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Why does comparative effectiveness research fall on deaf ears?

Many of the best practices discovered in the research community are never implemented in practice.  Why is this the case?  One reason is that physicians are overloaded with information and it is costly to cull the literature for best practice information.  This is especially true when best practices are not clearly identified or change over […]

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