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Archive for the 'Comparative Effectiveness' 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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Adding the patient perspective to health technology assessment

Health technology assessments (HTAs) aim to measure the cost effectiveness of a given treatment or set of treatments for a specific patient populations.  Often, these assessments are conducted from the point of view of the payer–either a national health system or the individual insurer perspective.  This payer focused perspective can often focus largely on treatment costs rather […]

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Extended Cost Effectiveness Analysis

Cost effectiveness analysis (CEA) examines whether treatment benefits outweight treatment costs on average for a given patient population. A 2016 paper by Verguet, Kim and Jamison examine the concept of extended cost effectiveness analysis (ECEA) which applies cost effectiveness methodologies to health care policies. The policies are evaluated over 4 domains: (1) health gains; (2) […]

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Should cost-effectiveness analysis ignore the price of the drug?

Cost effectiveness analysis (CEA) aims to examine whether the benefits of a treatment outweigh the costs.  However, whenever one is conducting a CEA a key question is benefits to whom and costs to whom.  For instance, a modestly efficacious  drug may be cost effective from the patient’s perspective if all or most costs are covered by insurance. […]

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How do we measure the value of and pay for biomedical innovation?

Dana Goldman, Samuel Nussbaum, and Mark Linthicum have an interesting post on the Health Affairs blog about innovation, value measurement and pricing.  The article mentions the new Innovation and Value Initiative, where I serve as the Director of Research.  An excerpt is below. New pricing mechanisms are needed to effectively link prices to value; we […]

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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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Incorporating the patient perspective into health technology assessments

Health technology assessments aim to evaluate the costs and benefits of various healthcare treatments and technology. Many organizations that conduct HTAs say they wish to incorporate the patient perspective. In practice, this does not happen often. When it does, there are a number of methodological complexities. How do you incorporate the patient perspective into HTA? A […]

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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 […]

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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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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 […]

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