To gauge the relative value of any health intervention the outcome needs to be measured and compared to some desired result. Cost effectiveness analysis is a tool used to compare the cost of outcomes from various interventions. For instance, preventive medical services are compared to other lifesaving interventions using the outcome life years saved. This allows public health advocates to decide how to allocate scare resources.
Category: Cost of Healthcare
Friday Links
- “You can very clearly halve your children’s risk of schizophrenia through polygenic selection, which costs only a few hundred dollars if you’re already doing IVF…. In a decade or two you can probably eliminate the risk entirely.”
- Roughly 90 percent of Americans are effectively blocked from opening an HSA.
- How to create HSAs in the Obamacare Exchanges. (National Review)
- Americans who trust the government to do the right thing most of the time: 10% Elites: 79% Super Elites: 89%. Maybe that’s because the elites run the government.
- What the future holds for weight loss drugs. (Bloomberg)
- Have economists oversold the idea of “moral hazard”?
Thursday Links
- Prescription drug pricing: Most cost-effectiveness analyses exclude probable end-of-patent, life cycle pricing – and set the initial price too low.
- Private approaches may be the best answer to public health problems.
- Rep Michael Burgess on why the CBO needs to consider the long-term benefits of preventive medicine.
- Looks like there are more deaths by fire than by ice. But there are still more deaths by cold than by warming.
Congress Wants to Reform Pharmacy Benefit Managers
Pharmacy Benefit Managers (PBMs) have been portrayed as a boogeyman for quite some time. PBMs manage drug benefits for health plans, including employee health plans, Obamacare, Medicare Advantage, Medicaid managed care and private insurers. PBMs raised the ire of independent pharmacies years ago because PBMs bargain down the fees pharmacists receive from government programs like Medicaid. For instance, most state fee-for-service (FFS) Medicaid programs pay small pharmacies dispensing fees that exceed $10 for a prescription, while some states pay small dispensing fees of more than $13 a prescription, while others pay more than $15. Dispensing fees are the professional fees (basically for counting pills and placing them in a bottle) in addition to the ingredient costs. Keep in mind that Walmart will dispense a month’s supply of certain generic drugs for a total cost of $4, a fee that includes the dispensing fee and the cost of the drugs themselves. Paying $15 to $20 for a Medicaid FFS prescription that Walmart sells to uninsured consumers for $4 seems excessively generous.