Aaron Carroll goes after one of the most pervasive myths in health care – that preventive care saves money:
“But money doesn’t have to be saved to make something worthwhile. Prevention improves outcomes. It makes people healthier. It improves quality of life. It often does so for a very reasonable price…Sometimes good things cost money.”
How does the UK manage to keep the costs of cancer drugs much lower than in the United States? Many think that it is through NICE’s recommendations to decline coverage for a drug if it does not meet specified cost-effectiveness thresholds – which our Medicare and Medicaid can’t. These authors explained how, this week in JAMA:
“As novel cancer treatments, such as immunotherapies, are introduced and new drugs are licensed for multiple indications, this challenge will increase. The recent increase in positive NICE recommendations for routine use likely reflects increased willingness by the industry to offer their products at a cost-effective price at launch to secure long-term availability in the NHS.”
This piece in STAT takes a critical view of the “Pay for Performance” reimbursement schemes that have been around for a while in health care:
“Subjecting doctors and hospitals to carrots and sticks hasn’t worked for several reasons. The most fundamental one: Clinician skill is not the only factor that determines the quality of care…Second, the certainty that sicker and poorer patients drag down doctors’ scores causes some doctors to avoid treating these patients, causing serious preventable illness and additional medical costs.”
File this one in under “bad performance measures”.