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  • PCSK9 Inhibitors and the Choice Between Innovation, Efficiency, and Affordability

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    JAMA. 2017; 318(8):711-712. doi: 10.1001/jama.2017.8907
  • Why It’s So Hard for Insurers to Compete Over Technology

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    JAMA. 2017; 318(8):687-688. doi: 10.1001/jama.2017.9971
  • Cost, Effectiveness, and Value: How to Judge?

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    JAMA. 2016; 316(14):1447-1448. doi: 10.1001/jama.2016.11516

    This Viewpoint discusses the value judgments that are always incorporated into payers’ and health systems’ assessments of the clinical- and cost-effectiveness of interventions and into their discussions whether to adopt them.

  • Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine

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    JAMA. 2016; 316(10):1093-1103. doi: 10.1001/jama.2016.12195

    This recommendation statement from the Second Panel on Cost-Effectiveness in Health and Medicine reviews methodological advances in cost-effective analyses and updates the 1996 recommendations for the conduct and report of cost-effective analyses.

  • The Next Chapter in Cost-effectiveness Analysis

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    JAMA. 2016; 316(10):1049-1050. doi: 10.1001/jama.2016.12844
  • Determining Value and Price in Health Care

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    JAMA. 2016; 316(10):1033-1034. doi: 10.1001/jama.2016.10922
  • JAMA August 16, 2016

    Figure 2: Incremental Cost-effectiveness Ratio (ICER) of PCSK9 Inhibitor Therapy Among Patients With Heterozygous Familial Hypercholesterolemia or Atherosclerotic Cardiovascular Disease

    The ICER for proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor therapy increases with the annual cost of PCSK9 inhibitor therapy. Blue, orange, and black data markers indicate the price at which PCSK9 inhibitor therapy would become cost-effective in the United States at willingness-to-pay thresholds of $150 000 per quality-adjusted life-year (QALY) ($6810), $100 000 per QALY ($4536), and $50 000 per QALY ($2261), respectively. In the base case, status quo statin plus PCSK9 inhibitor therapy is compared with status quo statin plus ezetimibe (black line). When PCSK9 inhibitor therapy costs less than $7049 per year (inflection in the graph), ezetimibe is eliminated by extended dominance and status quo statin plus PCSK9 inhibitory therapy is compared directly with status quo statin therapy (gray line). For reference, vertical lines include the list price of a 1-year supply of evolocumab in the United States and 3 European countries.
  • Cost-effectiveness of PCSK9 Inhibitor Therapy in Patients With Heterozygous Familial Hypercholesterolemia or Atherosclerotic Cardiovascular Disease

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    JAMA. 2016; 316(7):743-753. doi: 10.1001/jama.2016.11004

    This study estimates the cost-effectiveness of adding proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors to statin therapy for patients with heterozygous familial hypercholesterolemia (FH) or atherosclerotic cardiovascular disease (ASCVD).

  • JAMA August 16, 2016

    Figure 1: Probabilistic Sensitivity Analyses Showing the Proportion of Optimal Simulations as a Function of Drug Price

    At 2015 US prices and a threshold of $100 000 per quality-adjusted life-year (QALY), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were not cost-effective among patients with heterozygous familial hypercholesterolemia or atherosclerotic cardiovascular disease. Lowering the drug price or increasing the cost-effectiveness threshold would increase the proportion of simulations that are cost-effective. Vertical dotted lines show the list price of a 1-year supply of evolocumab in the United States ($14 100), the United Kingdom ($6427; the National Health Service receives an additional discount), Austria ($8110), and Finland ($8700).
  • Social Entrepreneurship: Improving Global Health

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    JAMA. 2016; 315(22):2393-2394. doi: 10.1001/jama.2016.4400

    This Viewpoint describes the efforts of social enterpreneurs, individuals and organizations who develop self-sustaining business models to deliver cost-effective health care and social services to poor and underserved communities around the world.

  • Cost-effectiveness of 10-Year Risk Thresholds for Initiation of Statin Therapy for Primary Prevention of Cardiovascular Disease

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    JAMA. 2015; 314(2):142-150. doi: 10.1001/jama.2015.6822

    This study compares the cost-effectiveness of using various 10-year atherosclerotic cardiovascular disease risk thresholds for initiating statin therapy.

  • JAMA July 14, 2015

    Figure 1: One-Way Sensitivity Analysis Showing the Optimal ASCVD Threshold as a Function of Statin Price

    ASCVD indicates atherosclerotic cardiovascular disease; QALY, quality-adjusted life-years. The optimal treatment threshold (using a cost-effectiveness threshold of $100 000/QALY) changes from ≥3.0% to ≥10.0% as statin price increases from $150/y to $1000/y (base-case value is $268/y). Optimal strategies are also shown for cost-effectiveness thresholds of $50 000/QALY and $150 000/QALY. No ASCVD treatment threshold was cost-effective for statin prices greater than $500/y using a cost-effectiveness threshold of $50 000/QALY. No ASCVD treatment threshold was cost-effective for statin prices greater than $1000/y using a cost-effectiveness threshold of $100 000/QALY.
  • Sources and Focus of Health Development Assistance, 1990–2014

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    JAMA. 2015; 313(23):2359-2368. doi: 10.1001/jama.2015.5825

    This Special Communication reports the amount of financial assistance high-income countries and private organizations provide to developing countries for health, and their areas of focus.

  • JAMA November 26, 2014

    Figure: Incremental Cost-effectiveness for Low-Molecular-Weight Heparin (LMWH; as Dalteparin) vs Unfractionated Heparin (UFH)

    Horizontal axis indicates difference in proportions between the 2 study drug venous thromboembolism rates; vertical axis, the difference in costs for the 2 compared strategies, across all patients in PROTECT.
  • Cost-effectiveness of Dalteparin vs Unfractionated Heparin for the Prevention of Venous Thromboembolism in Critically Ill Patients

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    JAMA. 2014; 312(20):2135-2145. doi: 10.1001/jama.2014.15101

    This prospective economic evaluation reports that use of LMW heparin for venous thromboembolism prophylaxis in critically ill patients was more effective than unfractionated heparin, with similar or lower costs.

  • Cost-effectiveness of Bariatric Surgery

    Abstract Full Text
    JAMA. 2013; 310(7):742-743. doi: 10.1001/jama.2013.276131
  • The Value of Low-Value Lists

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    JAMA. 2013; 309(8):775-776. doi: 10.1001/jama.2013.828
  • JAMA July 4, 2012

    Figure: Supportive Housing Cuts Costs of Caring for the Chronically Homeless

    A growing body of evidence suggests that it is more cost-effective to provide chronically homeless individuals with supportive housing than to allow these individuals to remain on the street, where they may require expensive public services.