What Is the Price of Life and Why Doesn't It Increase at the Rate of Inflation?

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Archives of Internal Medicine (Impact Factor: 13.25). 08/2003; 163(14):1637-41. DOI: 10.1001/archinte.163.14.1637
Source: PubMed
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    • "( Maciosek et al . , 2006 ) . From a population health perspective , most studies find that screening costs anywhere from $ 10 , 000 to $ 25 , 000 per year of life saved as compared to no screening ( Pignone et al . , 2002 ) . This is significantly less than the acceptable threshold of effectiveness ( $ 50 , 000 or less per year of life gained ) ( Ubel et al . , 2003 ) ."
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    ABSTRACT: Colorectal cancer (CRC) is the third most deadly cancer in the United States. While there are several risk factors associated with the development of CRC, the most effective way to prevent CRC deaths is to promote regular screening. Despite strong evidence for the cost effectiveness of screening, compliance with recommended screenings is very low. This paper investigates the impact of mandated insurance coverage for CRC screening on CRC screening rates using a sample of insured adults from the Behavioral Risk Factor Surveillance Survey (BRFSS) from 2001 to 2008. To date, 34 states have mandated private health insurance coverage of colorectal screening. These mandates should reduce the cost of screening for some but not all privately insured patients. We find no evidence that mandates increased screening among males age 50 to 64 overall, though we do find weak evidence that mandates may have increased endoscopic only screening rates among females. However, these effects seem to be driven by a decline in endoscopic only screening among older women that is not observed in younger women. For both men and women, we find little evidence that mandates decreased the fraction of individuals who obtained no recent CRC screening.
    Health Economics 12/2011; DOI:10.2139/ssrn.1962701 · 2.14 Impact Factor
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    • "The uncertainty of threshold levels creates some controversies. Although the threshold of US$ 50 000 or US$ 100 000 per QALY is widely used, Ubel et al. (2003) pointed out that inflation was not considered in that threshold. If the high range of the threshold was determined to be US$ 100 000 in 1982, it is not reasonable that the same value continues to be adopted until the present time. "
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    ABSTRACT: Although the threshold of cost effectiveness of medical interventions is thought to be 20 000- 30 000 UK pounds in the UK, and $50 000-$100 000 in the US, it is well known that these values are unjustified, due to lack of explicit scientific evidence. We measured willingness-to-pay (WTP) for one additional quality-adjusted life-year gained to determine the threshold of the incremental cost-effectiveness ratio. Our study used the Internet to compare WTP for the additional year of survival in a perfect status of health in Japan, the Republic of Korea (ROK), Taiwan, Australia, the UK, and the US. The research utilized a double-bound dichotomous choice, and analysis by the nonparametric Turnbull method. WTP values were JPY 5 million (Japan), KWN 68 million (ROK), NT$ 2.1 million (Taiwan), 23 000 UK pounds (UK), AU$ 64 000 (Australia), and US$ 62 000 (US). The discount rates of outcome were estimated at 6.8% (Japan), 3.7% (ROK), 1.6% (Taiwan), 2.8% (UK), 1.9% (Australia), and 3.2% (US). Based on the current study, we suggest new classification of cost-effectiveness plane and methodology for decision making.
    Health Economics 04/2010; 19(4):422-37. DOI:10.1002/hec.1481 · 2.14 Impact Factor
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    • "rrent cost - effectiveness ratio for renal di - alysis , however , is at least U . S . $ 129 , 000 per quality - adjusted life - year , accord - ing to a recent study ( Lee , Chertow , and Zenios 2009 ) , suggesting that current cost - effectiveness threshold limits should be raised to take into account societal preferences and medical inflation ( Ubel et al . 2003 ) ."
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    ABSTRACT: To estimate patients' elasticity of demand, willingness to pay, and consumer surplus for five high-cost specialty medications treating metastatic disease or hematologic malignancies. Claims data from 71 private health plans from 1997 to 2005. This is a revealed preference analysis of the demand for specialty drugs among cancer patients. We exploit differences in plan generosity to examine how utilization of specialty oncology drugs varies with patient out-of-pocket costs. We extracted key variables from administrative health insurance claims records. A 25 percent reduction in out-of-pocket costs leads to a 5 percent increase in the probability that a patient initiates specialty cancer drug therapy. Among patients who initiate, a 25 percent reduction in out-of-pocket costs reduces the number of treatments (claims) by 1-3 percent, depending on the drug. On average, the value of these drugs to patients who use them is about four times the total cost paid by the patient and his or her insurer, although this ratio may be lower for oral specialty therapies. The decision to initiate therapy with specialty oncology drugs is responsive to price, but not highly so. Among patients who initiate therapy, the amount of treatment is equally responsive. The drugs we examine are highly valued by patients in excess of their total costs, although oral agents warrant further scrutiny as copayments increase.
    Health Services Research 10/2009; 45(1):115-32. DOI:10.1111/j.1475-6773.2009.01059.x · 2.49 Impact Factor
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