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December 2015 

 
 
 

Table of Contents

  • Director’s Letter
  • CEVR News
  • CEA Registry Blog
  • CEVR in the Media
  • 2015 Publications
  • Recent Presentations and Invited Talks
  • Upcoming Events for CEVR Sponsors
  • New CEVR Staff
  • Career Opportunities
 
 
 

Director's Letter

Everyone it seems is talking about the need to do something about rising drug costs.  One of the most promising responses involves an attempt to tie prices to the value of prescription drugs, including initiatives from ACC/AHA, ASCO, ICER, Memorial Sloan Kettering, and ICER.  But, as my CEVR colleague, Josh Cohen, and I discuss in a recent New England Journal of Medicine Perspective, value is an elusive target, and the approaches also highlight analytic and implementation challenges.

CEVR was proud to co-host the International Pharmacoeconomics in Alzheimer’s Disease (IPECAD) conference in Boston on November 19-20, at which two dozen speakers presented new work on the economics of AD, including new estimates on the burden of the disease, and new modeling techniques.

Elsewhere, we have analyzed the “peculiar” economics of life saving therapies, and documented differences between Medicare and private payer coverage for medical devices.

Hope you have a great holiday season.

Peter Neumann, Sc.D.

 
 
 
 

CEVR News

Measuring the value of pharmaceuticals.  In a recent New England Journal of Medicine perspective, Peter Neumann and Joshua T. Cohen argue that recent value-based frameworks from ACC, ASCO, ICER, Memorial Sloan Kettering, and NCCN, are welcome initiatives but also reveal analytic challenges.

The peculiar economics of life-extending therapies.  Natalia Olchanski and colleagues review cost-effectiveness analyses in oncology and discuss the fact that conventional CEA methods may implicitly penalize therapies that add “expensive” life years for chronically ill patients.

 Private payers disagree with Medicare over medical device coverage about half the time.  In Health Affairs, James Chambers and colleagues analyze medical device national coverage determinations (NCDs) from 1999-2003 and find that NCDs were equivalent to the corresponding private payer policies roughly half of the time, more restrictive approximately a quarter of the time, and less restrictive about a quarter of the time.

 
 

CEA Registry Blog 

Visit the CEA Registry blog, a frequently updated resource for the health policy community. Blog posts range from research news updates to in-depth opinion pieces on timely topics.  The Registry contains 4,339 cost-utility analyses on a wide variety of diseases and treatments, along with over 12,000 standardized cost-effectiveness ratios and over 16,000 utility weights.

Recent Blog Posts:

From the NY Times: “No, Giving More People Health Insurance Doesn’t Save Money”

Are hematopoietic transplants effective among older adults with multiple myeloma?

 The state of cost-utility analysis in Asia

 
 
 

CEVR in the Media

“A prescription for sticker shock caused by drug costs.” The New York Times (Nov 23)

“Coverage of health care technology: Medicare vs. commercial market.” The Incidental Economist (Aug 7)

 “New alternatives to statins add to a quandary on cholesterol.” The New York Times (Aug 29)

“The growing use of cost-utility analysis in Asia.” ISPOR News & Press (July 21)

“No, giving more people health insurance doesn’t save money.” The New York Times (Aug 5)

“The 21st Century Cures Act and drug company promotion of real-world data.” Health Affairs Blog (May 15)

 
 
 

2015 CEVR Publications

Chambers JD, Cangelosi MJ, Neumann PJ. Medicare’s use of cost-effectiveness analysis for prevention (but not for treatment). Health Policy 2015 Feb (119)2:156-163.

Chambers JD, Chenoweth M, Cangelosi MJ, Pyo J, Cohen JT, Neumann PJ. Medicare is Scrutinizing Evidence More Tightly for National Coverage Determinations. Health Affairs 2015; 34(2):253–260.

Chambers JD, Chenoweth M, Thorat T, Neumann PJ. Private Payers Disagree With Medicare Over Medical Device Coverage About Half The Time. Health Aff August 2015 vol. 34 no. 8 1376-1382.

Chambers JD, Naci H, Wouters OJ, Pyo J, Gunjal S, Kennedy IR, Hoey MG, Winn A, Neumann PJ. An assessment of the methodological quality of published network meta-analyses: A systematic review. PLOS ONE 29 April 2015. 

Chambers JD, Thorat T, Pyo J, Neumann PJ. The Lag from FDA Approval to Published Cost-Utility Evidence. Expert Rev Pharmacoecon Outcomes Res. 2015 Jan 12:1-4

Lin P-J, Kent DM, Winn A, Cohen JT, Neumann PJ. Multiple Chronic Conditions in Type 2 Diabetes Mellitus: Prevalence and Consequences. AJMC 2015;21(1):e23-e34.

Neumann PJ, Cohen JT. Measuring the Value of Prescription Drugs. NEJM Perspective. 2015 Nov 18. [Epub ahead of print]

Neumann PJ, Saret C. When Does FDAMA Section 114 Apply? Ten Case Studies. Value in Health July 2015 (18) 5: 682-689.

Neumann PJ, Thorat T, Shi J, Saret CJ, Cohen JT. The Changing Face of the Cost Utility Literature, 1990-2012. Value in Health 2015. 18(2):271-277.

Olchanski N, Zhong Y, Cohen JT, Saret C, Bala M, Neumann PJ. The peculiar economics of life-extending therapies: a review of costing methods in health economic evaluations in oncology. Expert Rev Pharmacoecon Outcomes Res. 2015 Oct 19:1-10. 

Saret CJ, Winn A, Shah G, Parsons SK, Lin PJ, Cohen JT, Neumann PJ. Value of Innovation in Hematologic Malignancies: A Systematic Review of Published Cost-Effectiveness Analyses. Blood 2015 First Edition.

Thorat T, Lin PJ, Neumann PJ. The State of Cost-Utility Analyses in Asia: A Systematic Review. Value Health Regional Issues. 2015 May 7–13.

Winn AN, Shah GL, Cohen JT, Lin PJ, Parsons SK. The real world effectiveness of hematopoietic transplant among elderly individuals with multiple myeloma. J Natl Cancer Inst. 2015 May 28;107(8).

Zhong Y, Lin P-J, Cohen JT, Winn A, Neumann PJ. Cost-Utility Analyses in Diabetes: A Systematic Review and Implications from Real-World Evidence. Value in Health 2015;18(2):308-314.

 
 
 
 

Recent Presentations and Invited Talks

Academy of Managed Care Pharmacy Dyslipidemia Partnership Forum James Chambers, PhD, spoke about the policy options for managing the cost of PCSK9 inhibitors and other specialty drugs. (Sept 16)

Medicaid Leadership Policy Academy James Chambers, PhD, participated on a panel to discuss the costs of prescription medicines. (Sept 22)

Specialty Drug Panel in Washington, DC, Peter Neumann, ScD, spoke about measuring the value of specialty drugs. (Sept 30)

MassBio Conference Peter Neumann, ScD, presented on measuring value in health care. (Oct 5)

US Chamber of Commerce Annual Health Care Summit James Chambers, PhD, spoke about management approaches for specialty drugs and the role of the patient across the health care continuum. (Oct 20)

Massachusetts All-Payer Claims Database (MA APCD) User Symposium Natalia Olchanski, MS, spoke about her experience using the APCD data in research on Best opportunities for improving Massachusetts health within budget constraints as a panel discussant. (Nov 5)

ISPOR Europe Meeting James Chambers, PhD, presented two posters, titled “Disinvesting in low-value care: Opportunities and challenges” and “Fast-tracking innovation: A scorecard for the FDA’s expedited review process”. (Nov 7-11)

7th International Pharmacoeconomic Conference on Alzheimer’s disease (IPECAD), Paige Lin, PhD, and Peter Neumann, ScD, were on the Steering Committee and spoke about AD burden and policy. (Nov 19-20)

Above: Presentation at IPECAD Boston, November 2015

 

 
 
 

Upcoming Events for CEVR Sponsors

Annual Methods, Policy, and Data Symposium will be held on April 5, 2016 at the Mandarin Oriental Hotel in Boston, MA.

Health Policy Seminar Series Upcoming Speakers

December 16, 2015
Mark Friedberg, MD, MPP
Senior Natural Scientist, RAND Corporation
Practicing general internist, Brigham & Women’s Hospital

January 20, 2016
Ankur Pandya, PhD, MPH
Assistant Professor of Decision Science
Department of Health Policy and Management, Harvard School of Public Health

February 23, 2016
John Michael McWilliams, MD, PhD
Associate Professor of Health Care Policy, Harvard Medical School
Practicing general internist, Brigham & Women’s Hospital

April 20, 2016
David Auerbach, PhD, MS
Deputy Director for Research and Cost Trends, Massachusetts Health Policy Commission

May 11, 2016
Stéphane Verguet, PhD, MPP, MS
Assistant Professor of Global Health, Department of Global Health and Population, Harvard School of Public Health

CEVR sponsors receive full access to our Cost-Effectiveness Analysis Registry and our database of Medicare National Coverage Decisions, as well as free attendance at our webinars, and invitations to our invite-only Annual Methods, Policy, and Data Symposium. For more information on CEVR sponsorship benefits please contact Julie Lannon at JLannon@tuftsmedicalcenter.org.

 
 
 

CEVR Welcomes...

Tara Lavelle, PhD, joined CEVR as an Assistant Professor in September. Tara graduated from Harvard with a PhD in Health Policy. Tara's research includes evaluations of the cost-effectiveness of adult and child health interventions, as well as the development of novel methods for evaluating the health and economic outcomes of childhood illnesses, including autism spectrum disorder.  At CEVR, Tara will continue with this line of research, and expand her focus to conduct analyses using the CEA Registry to examine the trends and policy implications of previously published cost-effectiveness research.  

Jordan Anderson, BA, joined CEVR as a Research Assistant in September. Jordan graduated from Tufts University with a degree in Economics. Jordan’s research at CEVR focuses on payer coverage of multiple sclerosis medication and general medical devices. Jordan is also working on a research project regarding the history and benefits of vitamins.

Colby Wilkinson, BA, joined CEVR as a Research Assistant in June. Colby graduated from Tufts University with a dual degree in Quantitative Economics and Community Health. Colby’s research at CEVR focuses on quantifying variation in private payer coverage of rheumatoid arthritis drugs and evidentiary standards, as well as health gains associated with drugs given special designation by the FDA. 

CEVR Staff and friends, August 2015

 
 
 

Career Opportunities

CEVR is hiring! We are looking for a Research Assistant and Research Associate to join our team. We are also recruiting for two Post-Doctoral Fellowship positions. For more information please contact Julie Lannon at JLannon@tuftsmedicalcenter.org