Date and Time
April 19, 2006
1:30 PM - 3:00 PM

Availability
Open to the public
No RSVP required

Speaker
Stirling Bryan - Stanford University

"There is no question that financial and medical effects will be considered when making health care decisions at all levels of policy making; the only question is whether they will be considered well." (Power & Eisenberg, 1998)

This presentation will explore why the rallying call by Power and Eisenberg for the use of cost-effectiveness analysis (CEA) in U.S. health care has had very little impact. The seminar will draw upon a review of literature, and early data from case studies of U.S. healthcare organizations. The methodology is qualitative, and data collection has involved documentary analysis, interviews with key professionals and workshops. Where possible, interviews/workshops were audio-taped and transcribed. The views of key professionals in each organization will be discussed.

Four main sets of arguments will be explored.

1. The explicit use of CEA would be unpopular amongst health plan members and so potentially the plan's market share would be adversely affected.

2. Healthcare coverage decisions based on CEA might be subject to lawsuits and this fear is a constraint on the explicit use of CEA.

3. Alternative approaches to managing scarcity in health care, such as "skin in the game" approaches to limiting demand, are preferable.

4. The methods of CEA need to be strengthened before U.S. decisionmakers will make use of the technique.