To inform health-care decision-making, treatments are often compared with synthesizing results from a number of randomized controlled trials. The meta-analysis may not only be focused on a particular pairwise comparison but can also include multiple treatment comparisons by means of network meta-analysis. For time-to-event outcomes such as survival, pooling is typically based on the hazard ratio (HR).
Evidence-based health-care decision making requires comparisons of all relevant competing interventions. In the absence of randomized, controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best choice(s) of treatment.
Assessments of the medical and economic value of therapies in diseases such as cancer traditionally focus on average or median gains in patients’ survival. This focus ignores the value that patients may place on a therapy with a wider “spread” of outcomes that offer the potential of a longer period of survival. We call such treatments “hopeful gambles” and contrast them with “safe bets” that offer similar average survival but less chance of a large gain.
Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best treatment(s).
Prescription drug insurance is able to lower static deadweight loss without reducing incentives for innovation, with the result that the public provision of drug insurance can be welfare-improving, even for risk-neutral and purely self-interested consumers.
A drug-licensing model for health care is proposed which has the promise of increasing drug use without altering patients' out-of-pocket spending, health plans' costs, or drug companies' profits. In such a model, people would purchase annual drug licences that would guarantee unfettered access to a clinically optimal number of prescriptions over the course of a year.