IVI released the research protocol for its first project, which examines the quality of evidence and methods used in cost effectiveness analysis (CEA) in healthcare. The research protocol is available here.
This is the first research project in a series, which will look at issues of relevance to policy, value assessment practices or methods, economic questions related to value, or other topics identified as priority questions by our Panel of Health Advisors. Our first project looks at whether and how studies of cost effectiveness—an important tool for assessing and pointing the way toward greater efficiency in healthcare—vary in quality for different segments of the healthcare system. The purpose of this study is to identify ways we can improve the healthcare evidence base and support greater understanding of waste in healthcare.
Researchers have noted that the application of cost-effectiveness analyses (CEAs) is imbalanced across different types of health care interventions, with pharmaceutical CEAs far more prevalent relative to drug spending's share of total health care costs compared with CEAs on medical and surgical procedures. This is an important question because efficiency in the health care system depends on having an adequate degree of cost-effectiveness information from all types of interventions. IVI’s inaugural research project explores the possible causes of the imbalance by collecting and analyzing data on the characteristics of CEAs and the effectiveness studies that underlay them. Specifically, the project will collect and examine information on:
1. Source of data used to measure effectiveness,
2. Sponsorship of the CEA and underlying effectiveness studies,
3. Statistical techniques used to measure effectiveness,
4. Property rights for the intervention being studied, and
5. Other issues of interest, including time horizon, whether costs outside of the health care sector and other CEA elements are considered in the analysis, and degree of adherence to current CEA guidelines.
All IVI research projects are subject to review by an external (non-affiliated) peer reviewer, selected based on their expertise and independence. Scientific protocols and all final reports are subject to this peer review process, and reviewers' comments and the IVI researchers' responses are all released to the public. The external peer reviewer for this project is Anirban Basu; his comments, the IVI researchers' responses, and the original draft of the protocol are all available at the link above.
Two of the project's lead scientists, James Baumgardner and Peter Neumann, recently published a commentary on the Health Affairs blog that describes the need to expand CEA to non-drug contexts and sets the stage for this research project.
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