Health care spending growth and low-value care utilization are a shared international concern. To address these challenges, cost-effectiveness assessments are a common practice in other nations to educate coverage decisions for new services and medicines. However, gaps exist in the traditional approach to value assessment that must be addressed as the practice gains momentum in the United States.
In his latest editorial for The American Journal of Managed Care, National Pharmaceutical Council (NPC) Chief Science Officer and Executive Vice President Robert Dubois, MD, PhD, explores the pitfalls of assigning only one organization the responsibility to assess value for the entire health care landscape. In this article, Dr. Dubois challenges the cost-effectiveness model used in analyses by health care organizations, specifically the government-backed National Institute for Health Care Excellence (NICE) in the United Kingdom and the independent Institute for Clinical and Economic Review (ICER) in the United States. The incremental cost-effectiveness ratios produced by these organizations’ analyses, Dr. Dubois argues, do not fully reflect the value of new treatments and the diversity of patient characteristics and preferences. Instead he suggests that multiple assessments performed by multiple groups have the potential to help stakeholders make better educated decisions that will ensure high-value care.
Read Dr. Dubois’ commentary in this month’s The American Journal of Managed Care to learn more.