Health Economic Analysis

1.) Health Reform Targets Cost and Coverage

2.) Transparency Shapes Pharmaceutical R&D

3.) Designing Clinical Research for Better Patient Care

In 1989 the Health Care Financing Administration, now the Centers for Medicare and Medicaid Services, published proposed coverage criteria. This was the first time the governing body of Medicare had attempted to make its decision-making process explicit, and included within these proposed criteria was a stipulation of cost-effectiveness.2

The proposed cost effectiveness criteria created controversy among medical device manufacturers, professional societies, providers, and insurers, but remained in circulation until quietly withdrawn 10 years later.3 Since then, cost-effectiveness methodologies have continued to develop and cost-effectiveness data remain in demand, though their use in coverage decisions is not explicit.

Although the proposed Medicare cost-effectiveness criteria were withdrawn, changing U.S. demographics are making economic analyses more relevant. In '07 the first baby boomer reached age 65, and Medicare is bracing for an onslaught of services to be rendered in the coming decades.