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Archive for the 'Comparative Effectiveness' Category

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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Obamacare’s slow repeal?

While we are waiting for the King v. Burwell verdict, which could repeal large sections of Obamacare, the house of representatives has already approved rolling back some ACA provisions. Modern Healthcare reports: Lawmakers postponed final passage of the proposed Protecting Seniors’ Access to Medicare Act despite a majority voting in favor of the bill. The […]

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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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What does a NICE health economist do?

What role do health economists at the UK’s National Institute for Health and Clinical Excellence (NICE) play and how do they conduct their cost effectiveness analyses for new treatments? I answer this question today based on NICE’s own documents.  According to their guidelines manual, the role of the health economist in clinical guideline development is to: […]

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Theory vs. Reality: End of Life Care

Charles Ornstein is a well-regarded health journalist who has written extensively about end-of-life care. Then his mother became sick. How did his preconceptions about end-of-life care change (if at all) as a result of his experience. An excerpt from the full article is below.   I’ve always thought that the high cost of end-of-life care is […]

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Disease Management Programs Don’t Work

That is the conclusion of this study. More information below: Background The ARRA stimulus package included $2.2 billion for health care cost-effectiveness research focusing on chronic disease prevention and disease management initiatives. These programs aim to address increasing health care costs for a number of diseases, such as: cancer, diabetes, heart disease, obesity, and smoking-related illnesses. […]

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Five Reasons That Many Comparative Effectiveness Studies Fail To Change Patient Care And Clinical Practice

The Patient-Centered Outcomes Research Institute (PCORI) is poised to develop and oversee a vast portfolio of new comparative effectiveness research. For this endeavor to transform patient care, new evidence must be disseminated to clinicians and patients, understood and considered relevant, and used in the decisions that inform clinical care.  According to a Health Affairs paper […]

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