The Risk of Comparative Effectiveness Analysis for Decision Making Purposes
The purpose of comparative effectiveness analysis is ordinarily defined as a means to compare the benefits of drug A versus drug B. However, particularly in relation to cancer drugs, there is only drug A, and comparative effectiveness analysis tends to compare drug A to a quality adjusted threshold value, with a frequent conclusion that the cost of the drug is not worth the additional life given to the patient. Ordinarily, a societal perspective is used to deny the drugs, since the additional life may be worth the drug cost for the patient, although not to the payer. The British organization, the National Institute for Clinical Excellence (NICE) has denied many cancer drugs to their patients because the cost exceeds a threshold value. The Centers for Medicaid and Medicare are examining a similar process to deny treatments that exceed a quality adjusted price of $50,000. There are similar provisions in the Healthcare Reform Act. With the emphasis upon medications, medical procedures are not as subject to this comparative effectiveness scrutiny; procedures can frequently exceed the cost of medication treatments. However, each medication is considered separately; no analysis examines the total contribution of the treatment to the overall cost of healthcare. We examine different aspects of comparative analysis using techniques of data mining.
KeywordsCancer Drug Medical Expenditure Panel Survey Standard Gamble Perfect Health Home Health Care
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