What Is the Role of Cost-Effectiveness Evidence in US Health Care?

At an OHE seminar last week, Dr James Chambers of Tufts Medical School examined the role cost-effectiveness evidence plays in health care resource allocation in the US and the potential value of expanding that.

At an OHE seminar last week, Dr James Chambers of Tufts Medical School examined the role cost-effectiveness evidence plays in health care resource allocation in the US and the potential value of expanding that. His scope included both private sector insurers and public programmes.

Specifically for Medicare, the government programme that covers people 65 and over, Chambers discussed to what extent coverage decisions for medicines are consistent with cost-effectiveness evidence and what might be gained by explicitly including economic evidence in Medicare coverage policy — in terms both of aggregate health gains and cost-savings. His analysis considered the challenges associated with incorporating cost-effectiveness evidence into public sector coverage policy, including implications of the 2010 US health care reform legislation.

Dr Chambers is an Assistant Professor at the Tufts Medical Center Institute for Clinical Research and Health Policy Studies at the Tufts University School of Medicine in Boston, Massachusetts. He is involved in maintaining the Tufts Medical Center’s Medicare National Coverage Decisions database. His research interests include what factors influence medical technology coverage policy and the role of cost-effectiveness evidence in decision-making.