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Cost-effectiveness Analysis in the United StatesCost-effectiveness Analysis in the United States

JAMA. 2006;295(23):2722-2723. doi:10.1001/jama.295.23.2722-a
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AUTHOR INFORMATION

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

COST-EFFECTIVENESS ANALYSIS IN THE UNITED STATES

To the Editor: In their Special Communication, Drs Pearson and Rawlins1 discuss ways in which the United States could adapt the British National Institute for Health and Clinical Excellence (NICE) to the US context. They are building on earlier suggestions by Woolf,2 Bailit,3 and others to create an independent organization to help policymakers assimilate best evidence, which is strongly supported by the Ethical Force Program.4

But their central point that the United States must explicitly incorporate costs into coverage decisions is too narrow. Too many US citizens misunderstand and mistrust the complex and often opaque systems through which coverage decisions are made. Simply increasing the use of cost-effectiveness analyses (CEAs) to inform these decisions—no matter how well the CEAs are done—will not enhance understanding and trust in coverage decisions, given the complexity of these decisions and the acknowledged limitations of CEAs.5 Increased use of CEAs, without a concurrent comprehensive attempt to ensure that coverage decisions are recognized to be fair, could actually reduce trust in the system. A fair system for making coverage decisions should be transparent, participatory, equitable, consistent, sensitive to value, and compassionate.4

Financial Disclosures: None reported.

References
Pearson SD, Rawlins MD. Quality, innovation, and value for money: NICE and the British National Health Service.  JAMA. 2005;2942618-2622
PubMed
Woolf SH. The need for perspective in evidence-based medicine.  JAMA. 1999;2822358-2365
PubMed
Bailit H. When the benefit is in doubt, who decides?  J Am Geriatr Soc. 1998;46342-345
PubMed
Wynia MK, Cummins D, Fleming D.  et al. Oversight Body of the Ethical Force Program.  Improving fairness in coverage decisions: performance expectations for quality improvement.  Am J Bioeth. 2004;487-100
PubMed
Kassirer J, Angell M. The journal's policy on cost-effectiveness analysis. . 1994;331669-670
PubMed

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Pearson SD, Rawlins MD. Quality, innovation, and value for money: NICE and the British National Health Service.  JAMA. 2005;2942618-2622
PubMed
Woolf SH. The need for perspective in evidence-based medicine.  JAMA. 1999;2822358-2365
PubMed
Bailit H. When the benefit is in doubt, who decides?  J Am Geriatr Soc. 1998;46342-345
PubMed
Wynia MK, Cummins D, Fleming D.  et al. Oversight Body of the Ethical Force Program.  Improving fairness in coverage decisions: performance expectations for quality improvement.  Am J Bioeth. 2004;487-100
PubMed
Kassirer J, Angell M. The journal's policy on cost-effectiveness analysis. . 1994;331669-670
PubMed
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