Using CEA to Define Low-Value Care

Ankur Pandya In Media Hub Explaining Concept.

CHDS faculty member Ankur Pandya makes the case for using cost-effectiveness analysis to define low-value care in “Adding Cost-Effectiveness to Define Low-Value Care” published in JAMA.

Pandya shows that common approaches to identifying and studying low-value care in the United States ignore costs, instead focusing on services that harm health (or show no clinical benefit). In other words, “no-value” care has been studied more than “low-value” care in the US. Incremental cost-effectiveness ratios, which are the main results used in cost-effectiveness analyses, can be used to identify low-value health care services that improve the health of patients but are not worth the additional costs required to achieve these health care gains. Incremental cost-effectiveness ratios greater than $100 000 to $150 000 per quality- adjusted life-year (QALY) suggest low-value health care in the United States.

Using data from the Tufts Cost-Effectiveness Analysis Registry, Pandya identified 331 US cost-effectiveness analyses published since 2005 with incremental cost-effectiveness ratios >$150,000/QALY. He concludes, “Cost-effectiveness analysis provides a systematic and quantitative basis to distinguish high- from low-value health care for services that improve the health of patients, and it could be a useful tool in the current efforts to identify and reduce low-value health care in the United States.”

The CHDS Media Hub collaborated with Pandya to design and produce a short video in which he describes the ideas behind a push towards value-centered care:

Video Production Credit: Jake Waxman, CHDS Media Hub

Learn more: Read Dr. Pandya’s preliminary publication about this topic.

More about the CHDS Media Hub

The CHDS Media Hub combines a physical brainstorming space with a laboratory-like digital environment to prototype, pilot and produce educational multimedia for teaching, learning and policy translation. If you are interested in collaborating with the CHDS Media Hub to create novel multimedia to effectively communicate your research findings, please contact the Media Hub Director, Jake Waxman.

Learn more: Explore the CHDS page about cost-effectiveness analysis.
Learn more: Read more about cost-effectiveness analysis in the CHDS repository.

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