What Should the Role of CEA be in Health Policy and Medical Decision Making?

Monday, October 20, 2014
5:30 pm EST

What should the role of CEA be in health policy and medical decision making?
How to make CEA more impactful in Health Policy

Cost-effectiveness analysis is explicitly forbidden in some areas of U.S. health policy (CMS, PCORI) while other countries routinely utilize CEA in coverage decisions.  In an era where health care cost containment is paramount, what is the role of CEA or what are alternative approaches?  The purpose of this symposium is to examine current U.S. barriers to applying CEA to health policy and medical decision making, explore how other countries have applied CEA, and to explore alternatives to CEA that could improve policymaking and medical decision making. 

The learning points include:

  1. What are current barriers to CEA influence on policy and medical decision making (in the US and in the UK)?

  2. How do different countries apply CEA at the level of policymakers, providers, and patients?

  3. How have countries tried to garner buy-in from the population for the use of CEA in Health Policy Decision Making.

  4. Potential alternatives to CEA that could be used to guide decisions about resource allocation for health policy and medical decisions?


Presenters: 

  • Lisa Prosser, PhD is an associate Professor at the University of Michigan School of Public Health. Dr. Prosser's research on the economic impact of influenza vaccination has been used in setting national vaccine policy for children and for prioritizing subgroups in vaccination shortage years. She is a member of the evidence review group for the Advisory Committee on Heritable Disorders in Newborns and Children. Dr. Prosser was the founding decision scientist for the Institute for Clinical and Economic Review.

    Dr. Prosser is being asked to address the following questions:

    1. How we do we use CEA for health policy and medical decision making in the US currently?
    2. What should/could our use of CEA in the US look like?
    3. What is the right place for CEA (the bedside? Govt decision making?
    4. What alternative to CEA could we introduce in the US that would help make decisions about resource allocation for health policy and medical decisions?

  • Michael O’Grady is a Senior Fellow in the Health Care Research for NORC at the University of Chicago and a Principal of O’Grady Health Policy LLC, a private health consulting firm.  His current research is concentrated on the interaction between scientific development and health economics, with a particular concentration on diabetes and obesity.  From 2003 to 2005, he was the Assistant Secretary for Planning and Evaluation at HHS, where he directed both the policy development and policy research across the full array of issues confronting the Department.  During his tenure as the Assistant Secretary, he increased the quality and rigor of ASPE’s research and analysis, providing rapid and critical analyses of legislative and regulatory proposals.  Prior to his Senate confirmation as the Assistant Secretary, he served as the senior health economist on the majority staff of the Joint Economic Committee of the U.S. Congress. Previously, he held senior staff positions at the Senate Finance Committee, the Bipartisan Commission for the Future of Medicare, the Medicare Payment Advisory Commission and the Congressional Research Service at the Library of Congress.

    Dr. O’Grady has been asked to represent the perspective of US political resistance to the use of CEA in health policy and medical decision making. He is being asked to address the following questions:

    1. Why is there resistance to uptake of CEA to inform health policy in the US and what are the political barriers.
    2. What sort of changes would have to take place for CEA to be widely used in the US for these decisions.
    3. What is the right place for CEA (the bedside? Govt decision making?
    4. What alternative to CEA could we introduce in the US that would help make decisions about resource allocation for health policy and medical decisions?

  • Mark Sculpher is Professor of Health Economics and is Director of the Programme on Economic Evaluation and Health Technology Assessment. He is also Deputy Director of the Policy Research Unit in Economic Evaluation of Health and Care Interventions (EEPRU). Mark has extensive experience with NICE where he chaired NICE's 2004 Task Group on methods guidance for economic evaluation and was a member of the Methods Working Party for the 2008 update of this guidance.  He was also a member of the Commissioning Board for the UK NHS Health Technology Assessment Programme. 

    Dr. Sculpher is being asked to represent the European perspective on how CEA is currently being used to inform health policy and barriers to its use.  He is being asked to address the following questions:

    1. How we do other countries (in Europe or limited to the UK) use CEA for health policy and medical decision making currently?
    2. What are barriers to the use of CEA?
    3. What is the right place for CEA (the bedside? Govt decision making?
    4. Is CEA the right mechanism for controlling healthcare costs?
    5. What alternative to CEA could we introduce in the US that would help make decisions about resource allocation for health policy and medical decisions?


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