The Patient Not in the Room

Since 2009, the amount that workers pay for health insurance has increased 71% while wages have increased 26%–yet another demonstration that the U.S. health care system cannot provide affordable, high-quality care to all Americans. In their recent article, Vanness and colleagues explored the best way to establish a cost-effectiveness threshold for policy considerations. Such measures could profoundly affect everything from clinical guidelines to insurance coverage policies to Medicare negotiation of drug prices.

In response to the Vanness paper, ICER’s President Steve Pearson wrote a companion editorial about the need to care for not only the patients right in front of us, but also the many other patients not in the room: “While every added dollar the US spends on health care may generate added health, at least for those directly benefiting from that extra spending, it also puts more pressure on health insurance premiums, harming patients not in the room… It is time for a renewed push to get policymakers, clinicians, and the public to recognize that when prices for services exceed a threshold in relation to their benefits, real harm comes to American patients. A ‘homegrown’ US cost-effectiveness threshold that is rooted in evidence will facilitate a more honest public dialogue about value and fairness. It’s time to advance the use of cost-effectiveness analysis to inform a system that takes care of everyone, including those patients not in the room.” Read the full article here.

(Source: Steve Pearson; The Patient Not in the Room. Annals of Internal Medicine; November 2020)