Incorporating costs into comparative effectiveness research
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Research insights
- Contributor(s):
- Gluck, Michael E. AcademyHealth.
- Publication:
- [Washington, D.C.] : AcademyHealth, [2009]
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Comparative Effectiveness Research -- economics Comparative Effectiveness Research -- methods Cost-Benefit Analysis Economics, Medical Quality-Adjusted Life Years Humans United States
- Genre(s):
- Technical Report
- Abstract:
- Comparative-effectiveness research attempts to establish the relative health benefits of different drugs, medical devices, diagnostic and surgical procedures, diagnostic tests, and medical services as a tool to improve health care outcomes and quality. Cost-effectiveness analysis, usually expressed as the cost of a medical technology per quality-adjusted life year (QALY) achieved, is a formal economic tool for comparing the relative value of medical technologies. Perspectives about the appropriateness and methods of incorporating costs into comparative effectiveness research differ greatly. Proponents of examining costs alongside health outcomes point to the fact that costs are already a part of health care discussions including decisions about coverage and payment for health care services and budgetary deliberations about public sources of insurance. They argue in favor of making these considerations systematic and transparent. Among the arguments against incorporating costs into comparative effectiveness analysis are public discomfort and political challenges to using cost-effectiveness for decision-making, inherent biases in cost-effectiveness analysis against new and less well-proven technologies, and difficulties in measuring costs and health benefits. They also argue that reducing uncertainty in health care through clinical effectiveness research is a more valuable use of scarce resources than is cost analysis. Alternatives to formal cost-effectiveness analysis for incorporating cost considerations into comparative effectiveness research include analyzing higher cost services first and requiring higher standards of evidence for high cost services. Pay-for-performance programs and other innovations in payment policy are yet other strategies to promote the use of higher value services. For comparative effectiveness research that does explicitly incorporate costs, there are a variety of "best practices" and prior experiences to draw upon. In addition to several states that use cost-effectiveness analysis to guide their public insurance programs, almost all industrialized countries' health insurance schemes use estimates of the relative value of health care services to make coverage and payment decisions.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- NLM Unique ID:
- 101552807 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101552807