Developing a value framework for cancer drugs can sound like an arcane exercise without much relevance to clinical care. Restate it as a question of how, and how much, to pay for cancer drugs, and you’ve got everyone’s attention. Current and potential value frameworks are the subject of a special issue of Value in Health and ongoing examination by the Gant Precision Cancer Medicine Consortium at the University of Pennsylvania.
It seems self-evident: one way to address the epidemic of opioid deaths is to make prescription opioids harder to misuse. OxyContin, for example, is especially dangerous when it is crushed for ingestion, inhalation, or injection. In 2010, the FDA approved a reformulated, abuse-deterrent version of OxyContin that made the pill difficult to crush or dissolve. The new version immediately replaced the old one, marking a substantial reduction in the supply of abusable prescription pain relievers.
Our colleagues at the Wharton Public Policy Initiative have released a new Issue Brief, The Economic Realities of Replacing the Affordable Care Act, by LDI Senior Fellow Hanming Fang, PhD. In it, Dr. Fang uses a new model of labor and health insurance market dynamics to simulate the long-run effects of the ACA's mechanisms, thus shedding some much-needed light on the repeal-and-replace debate.
“Pay more for drugs that do more.” Although few would argue with the concept of paying for value, the mechanism for doing so has thus far eluded our multi-payer, market-based system. The Gant Precision Cancer Medicine Consortium at the University of Pennsylvania looked past US borders to learn about mechanisms in other countries, in its quest to recommend sustainable frameworks for valuing precision cancer drugs.
We recently convened an expert roundtable to tackle how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable. This got us thinking - while the process by which ineffective practices or technologies are abandoned is neither simple nor automatic, even the language used to describe it is not clear. And language matters. It often reflects an unstated focus on one mechanism or one level of decision-making. Here we review, and potentially clarify, the terminology.
As the latest jobs report shows, growth in employment in the health care sector continues to be, well, healthy. Others have pointed out that this may not be a good thing, especially if it crowds out jobs in other industries, taking up resources that would otherwise go to producing more valuable goods and services.
At a recent campus-wide opioid task force at Penn, one noted researcher and clinician pointed out a painful truth: “We know how to treat addiction; it’s the systems that aren’t responding to the need.”