CHDS faculty member Ankur Pandya presented “CEA in the USA: A Quantitative Approach to Identify Low-Value Care” at a HPM Research Seminar.
Dr. Pandya discussed how in U.S. health policy, low-value care is typically defined by services that both increase costs and do not show significant clinical benefit. However, many services improve health but are not worth their incremental costs. As an example, high-priced cancer drugs could improve life expectancy by modest amounts but at large costs. Cost-effectiveness analysis (CEA) uses incremental cost-effectiveness ratios (ICERs) to quantify the tradeoff between health gains versus costs; in the U.S., ICERs>$150,000/quality-adjusted life year (QALY) are typically considered cost-ineffective (i.e., low value).
Dr. Pandya and team use the Tufts Medical Center CEA Registry database to ask a series of questions for U.S. health policy, including 1) what are common features among these types of low-value services?, 2) what do clinical guidelines say about these services?, and 3) how much money does the U.S. spend on these services?