Unbiased Analysis of Today's Healthcare Issues

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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Why does cost effective care spread so slowly

According to Fuchs and Millstein, here’s why: Insurers hesitation to standardize coverage.  Standardization of coverage would force insurance companies to compete primarily on the basis of price, which would put pressure on their profits. Employers bear too much of the marginal cost from employees choosing expensive health plans.  Because companies wish to avoid alienating employees, […]

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Who’s running the Patient-Centered Outcomes Research Institute (PCORI)?

As part of Health Reform, the government created the a center to study clinical effectiveness of different health treatments.  This center, known as the Patient-Centered Outcomes Research Institute (PCORI), “does not have the power to mandate or even endorse coverage rules or reimbursement for any particular treatment.”  What leverage does the Institute have?  Not too […]

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Patient Heterogeneity and Comparative Effectiveness Research

According to Kathleen Lohr, the most pressing issues for comparative effectiveness research (CER) include: 1) how to conduct CER for heterogeneous patient populations and 2) ways to implement longitudinal investigations to capture long-term health outcomes.  Today I will focus on measuring patient heterogeneity.  Although it makes sense to take into account differences across patients, measuring […]

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The Impact of Comparative Effectiveness Research on Health Care Spending

Comparative Effectiveness Research (CER), as it name suggests, compares how well different medicines treat a given disease.  Politicians claim that using CER findings can help improve quality and decrease cost.  If one treatment produces better health outcomes on average than another and also costs less, we should always make people use that treatment, right? Not […]

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Comparative Effectiveness vs. Cost Effectiveness Research

Comparative Effectiveness has been a hot topic in health services research. According to a recent article in the New England Journal of Medicine, “the American Recovery and Reinvestment Act of 2009 authorizes the expenditure of $1.1 billion to conduct research comparing ‘clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used to […]

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