Prof helped update guide to analyze cost-effective care

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Prof helped update guide to analyze cost-effective care

New recommendations, used around the world, reframe the cost-benefit considerations that underlie healthcare interventions
Bobbi Nodell

A panel of experts from the United States and Canada has updated 20-year-old guidelines and recommendations for evaluating cost-effectiveness in health and medicine – guidelines used around the world to make healthcare decisions.

“These methods and guidelines are both important and timely given the increase in healthcare costs,” said panel member Anirban Basu, UW professor of pharmacy and health services and adjunct professor of economics. [1:36 audio clip: Basu discusses the changes.]

The new guidelines were recently published in the Journal of the American Medical Association

The panel recommended several key changes, including:

  • Using an “Impact Inventory” that comprehensively lists the effects of a healthcare intervention to ensure that all consequences are considered – including those to patients, caregivers, social services and others outside healthcare. This tool also allows analysts to examine impacts that may be most important to stakeholders.
  • Broadening the scope of the Reference Cases, a standard set of methodologies to raise the quality of analysis by creating comparable measures. 
  • A reporting checklist and guidelines for transparency that identifies assumptions underlying any analysis and discloses potential conflicts of interest.

anirban basu
Anirban Basu is a UW professor of pharmacy and health services.
picture of Anirban Basu

Basu said the guidelines are not intended to promote the rationing of healthcare but rather to shed light on the most cost-effective interventions so policies can be enacted to promote them.

The recommendations build on the original work of the 1996 Panel on Cost-Effectiveness in Health and Medicine, convened by the U.S. Public Health Service. They are intended to guide decision-makers in analyzing evidence, reporting standardized results, incorporating perspectives of both healthcare systems and society, and weighing ethical issues in analyses of cost-effectiveness. 

The second round was primarily funded by grants from the Agency for Healthcare Research and Quality, Robert Wood Johnson Foundation and the Bill & Melinda Gates Foundation.

“As healthcare costs continue to rise at unsustainable rates, these recommendations provide a framework for comparing the relative value of different healthcare interventions, said Gillian D. Sanders, Duke University professor of medicine and a panel co-chair.

The panel included co-chair Peter J. Neumann, Tufts University professor of medicine and director of Tufts Center for the Evaluation and Risk in Health, and members Dan W. Brock (Harvard Medical School), David Feeny (McMaster University), Murray Krahn (University of Toronto), Karen M. Kuntz (University of Minnesota), David O. Meltzer (University of Chicago), Douglas K. Owens (VA Palo Alto Health Care System and Stanford University), Lisa A. Prosser (University of Michigan), Joshua A. Salomon (Harvard T.H. Chan School of Public Health), Mark J. Sculpher (University of York, UK), Thomas A. Trikalinos (Brown University), Louise B. Russell (Rutgers University), Joanna E. Siegel, and Theodore G. Ganiats (University of California – San Diego School of Medicine).

A book containing the panel’s discussions and recommendations will be published by Oxford University Press by year's end.