While the details of value measurement continue to be vigorously debated, nearly unprecedented consensus has emerged over the need to align reimbursement and utilization with value. More controversial, however, is the role of budgetary criteria in determining value and in governing access to health care technologies. The case for adding budgetary tests to measure value on top of traditional value assessments is problematic on several levels.
Commentary 5/26/17Are Biopharmaceutical Budget Caps Good Public Policy?
Medical innovation has generated significant gains in health over the past decades, but these advances have been accompanied by rapid growth in healthcare spending. Faced with a growing number of high-cost but high impact innovations, some have argued to constrain prices for new therapies – especially through global caps on pharmaceutical spending and limits on prices for individual drugs. We show that applying this threshold to past innovations would have limited access to many highly valuable drugs such as statins and anti-retrovirals. We also argue that budget caps violate several important principles of health policy.READ MORE
Commentary 5/26/17Rapid Biomedical Innovation Calls For Similar Innovation In Pricing And Value Measurement
To balance physician prescribing of state-of-the-art drugs and patient desires to access them with the fiscal realities of high treatment costs, many governments have turned to health technology assessment (HTA) bodies to identify “high value” treatments. The authors discuss the history of HTA in the US, the issues of conducting HTA in the US context, and the need for innovation in how value is measured and linked to reimbursement.READ MORE