Saving Medicare Dollars: Moving from the SGR to Bundled Payments

The goal of Medicare is to provide protection for elderly Americans against the financial risk associated with illness, and in the process provide beneficiaries with access to high quality care.  Our challenge is to accomplish those goals in a fiscally sustainable manner. In this article, Michael Chernew, Darius Lakdawalla, and Dana Goldman emphasize that the [...]

2017-07-03T23:45:47-06:00February 12th, 2012|Publications, Viewpoints|

Conducting Indirect-Treatment-Comparison and Network-Meta-Analysis Studies: Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices—Part 2

Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best treatment(s). Mixed treatment comparisons, a special case of network meta-analysis, combine direct evidence [...]

2017-07-03T22:45:35-06:00June 12th, 2011|Publications, Research|

Interpreting Indirect Treatment Comparisons and Network Meta-Analysis for Health-Care Decision Making: Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 1

Evidence-based health-care decision making requires comparisons of all relevant competing interventions. In the absence of randomized, controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best choice(s) of treatment. Mixed treatment comparisons, a special case of network meta-analysis, combine direct [...]

2017-07-03T22:44:02-06:00June 12th, 2011|Publications, Research|

Network Meta-analysis of Survival Data with Fractional Polynomials

Pairwise meta-analysis, indirect treatment comparisons and network meta-analysis for aggregate level survival data are often based on the reported hazard ratio, which relies on the proportional hazards assumption. This assumption is implausible when hazard functions intersect, and can have a huge impact on decisions based on comparisons of expected survival, such as cost-effectiveness analysis. As [...]

2017-07-03T22:40:29-06:00May 1st, 2011|Publications, Research|

How Cancer Patients Value Hope and the Implications for Cost-Effectiveness Assessments of High-Cost Cancer Therapies

Assessments of the medical and economic value of therapies in diseases such as cancer traditionally focus on average or median gains in patients’ survival. This focus ignores the value that patients may place on a therapy with a wider “spread” of outcomes that offer the potential of a longer period of survival. We call such [...]

2017-07-03T22:48:04-06:00April 30th, 2011|Publications, Research|

Network Meta-analysis of Parametric Survival Curves

To inform health-care decision-making, treatments are often compared with synthesizing results from a number of randomized controlled trials. The meta-analysis may not only be focused on a particular pairwise comparison but can also include multiple treatment comparisons by means of network meta-analysis. For time-to-event outcomes such as survival, pooling is typically based on the hazard [...]

2017-07-03T22:42:18-06:00April 17th, 2011|Publications, Research|

Innovation and the Welfare Effects of Public Drug Insurance

Prescription drug insurance is able to lower static deadweight loss without reducing incentives for innovation, with the result that the public provision of drug insurance can be welfare-improving, even for risk-neutral and purely self-interested consumers. The level of welfare improvement achieved is dependent on the design of insurers’ cost-sharing schedules and the size of such [...]

2017-07-03T22:49:59-06:00November 30th, 2008|Publications, Research|

Drug Licenses: A New Model for Pharmaceutical Pricing

A drug-licensing model for health care is proposed which has the promise of increasing drug use without altering patients' out-of-pocket spending, health plans' costs, or drug companies' profits. In such a model, people would purchase annual drug licences that would guarantee unfettered access to a clinically optimal number of prescriptions over the course of a [...]

2017-07-03T23:18:43-06:00January 31st, 2008|Publications, Research|