Evidence map›Paper›PMID 35219599›Full record

ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2022

Affordability and Value in Decision Rules for Cost-Effectiveness: A Survey of Health Economists.

Alyssa Bilinski, Evan MacKay, Joshua A Salomon, Ankur Pandya

Abstract read
In one paragraph

Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Alyssa BilinskiBrown School of Public Health, Providence, RI, USA. Electronic address: alyssa_bilinski@brown.edu.
Evan MacKayHarvard Graduate School of Arts and Sciences, Cambridge, MA, USA.
Joshua A SalomonStanford University School of Medicine, Stanford, CA, USA.
Ankur PandyaCenter for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Funding

PROGRAM FOR AIDS CLINICAL RESEARCH TRAINING (PACRT)T32AI007433 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI MARK J SIEDNER · 1992 to 2026
$11.4M
NIAID NIH HHS T32 AI007433
6 · The paper itself

Abstract

objectivesNew health technologies are often expensive, but may nevertheless meet standard thresholds for cost effectiveness, a situation exemplified by recent hepatitis C cures. Currently, cost-effectiveness analysis (CEA) does not supply practical means of weighing trade-offs between cost-effectiveness and affordability, particularly when costs and benefits are temporally separated and in health systems with multiple payers, such as the United States. We formally characterized disagreements in CEA theory and identified how these trade-offs are presently addressed in practice.

methodsWe surveyed 170 health economics researchers.

resultsWhen presented with a hypothetical cost-effective drug therapy in the United States that would require 20% of a state's Medicaid budget over 5 years, 34% of survey respondents recommended that policy makers fund the drug for all patients and 26% for a subset. By contrast, 26% recommended against funding the drug. We found additional disagreement regarding whether the willingness-to-pay threshold should be based on the budget (42%) or societal preferences (41%) and identified 4 approaches to weighing cost-effectiveness and affordability. A total of 61% of respondents did not believe that the threshold used in their last article (most often 1×-3× per capita gross domestic product) represented either the budget or societal willingness-to-pay threshold.

conclusionsWe use these findings to recommend metrics that can inform translation of CEA theory into practice. By contextualizing cost and value, researchers can provide more actionable policy recommendations.

Indexed as

BudgetsDrug CostsCost-Benefit AnalysisGross Domestic ProductHumansQuality-Adjusted Life YearsSurveys and Questionnairesallocative efficiencybudget impactcost-benefit analysiscost-effectivenessgovernment expenditures and healthhealth

Identifiers

PMID35219599
PMCPMC9342917

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.