For anyone interested in the health care spending (and its growth) in the Unites States, Health Affairs has recently given a great historical review of the topic. This post tracks the rate of growth since the 1960s, and also offers some explanation as to why the rate of growth has slowed or accelerated at different times.
“The growth in prices for personal health care goods and services averaged 4.7 percent between 1961 and 2013, faster than the average growth in economy-wide prices (as measured by the GDP price index) of 3.5 percent over the period. The year-to-year differences in personal health care and economy-wide price growth reflect excess medical inflation, which has varied significantly over time.” Continue reading Health Policy Updates: November 29 2015
Oncology clinical trials have long come under criticism for studying drugs based on “surrogate outcomes” – effects other than actually extending patient’s lives. Common surrogate outcomes include things like shrinkage of tumors on CT scans and reductions in abnormal blood tests. These things can certainly be plausible indicators that the cancer treatment is working, but fall short of demonstrating the true goal of treatment, which is to save and extend lives from cancer. In recent years, the FDA has approved many cancer drugs on the bases of improvements in surrogate outcomes alone.
New research suggests that most cancer drugs approved on such terms – without evidence of life extension at the time of FDA approval – actually don’t extend patients’ lives once more definitive data comes in. Huge numbers of cancer patients are receiving treatments that, to the best of our knowledge, do not actually make them live any longer.
“With several years of follow-up, 31 (86%) of [36 drugs approved on the basis of surrogate endpoints] have unknown effects on overall survival or fail to show gains in survival” Continue reading Health Policy Updates: November 7 2015
More on the ongoing consolidation arms race between health insurers and hospitals.
“As some of the nation’s largest health insurers plan to merge, a new report raises fresh concern over the lack of competition in the private Medicare market. The analysis, released on Tuesday, concludes “there is little competition anywhere in the nation.” Continue reading Health Policy Updates: August 30 2015
We learn today that the FDA is considering approval of a new cholesterol drug, alirocumab.
As far as I can tell based on the evidence we have so far, this is a prime example of how new technology functions to increase health care costs, rather than decrease them. Continue reading New, expensive cholesterol med gets the go-ahead?
Many chemotherapy drugs are very expensive, but do little to improve patients’ survival. Here’s another example.
This post is about new research presented at the 2015 American Society of Clinical Oncology meeting.
The researchers looked at the cost-effectiveness of a new-ish chemotherapy for colon cancer, regorafenib, which costs about $10,000 per month. Basically, the research question is, “are we getting an appropriate bang for the buck in using this medication?” The verbiage itself is pretty dense, so I’ll quote and translate:
Continue reading Chemotherapy and cost-effectiveness