Evaluating care that improves health but isn’t cost-effective

Just because a particular health care service is considered not cost effective doesn’t mean it shouldn’t be used, according to a recent article co-authored by Harvard T.H. Chan School of Public Health’s Ankur Pandya.

In a March 10, 2021, article in JAMA Health Forum, Pandya, associate professor of health decision science, and his co-authors suggested five questions that health policy makers should consider when trying to evaluate care—for instance, cholesterol therapy or cancer treatment—that improves health but is cost-ineffective.

For example, one question is: Do ethical arguments outweigh cost effectiveness? There may be ethical principles to consider such as the obligation not to inflict harm on others, disease severity, or concerns over disparities, the authors wrote.

Another question is: Can the price be lowered? Policy makers may be able to lower prices for some health services, perhaps by renegotiating reimbursements, according to the authors.

“Withholding health-improving but cost-ineffective services is the last resort, but a necessary step, to get the most return from finite health care dollars,” the authors wrote.

Read the JAMA Health Forum article: Responding to Health-Improving but Cost-Ineffective Care