David Wamble (
Michael Ciarametaro is vice president of research at the National Pharmaceutical Council, in Washington, D.C.
Health Aff (Millwood). 2019 Jan;38(1):68-75. doi: 10.1377/hlthaff.2018.05158.
The continued rise in health care spending has led to an intense debate among policy makers and other health care stakeholders on how to best manage increasing costs, leading to a focus on cost increases with little consideration of the associated change in outcomes. We identified the extent to which increased medical intervention spending on seven prevalent chronic conditions in the US over a twenty-year period has been a good investment. The results provide disease-level cost-effectiveness ratios for comparing changes in medical care spending to changes in health outcomes for patients diagnosed with one of the conditions. This study has two key findings: First, dollars spent on medical care can be a source of high value creation, and such investment should continue. Second, significant variability in value exists across diseases, which highlights the need for disease-specific spending approaches.
医疗保健支出的持续增长在政策制定者和其他医疗保健利益相关者中引发了激烈的争论，即如何最好地管理不断增加的成本，这导致人们关注成本的增加，而很少考虑相关结果的变化。我们确定了在过去二十年中，美国七种常见慢性病的医疗干预支出增加在多大程度上是一项良好的投资。研究结果为比较患者医疗保健支出变化与健康结果变化提供了疾病层面的成本效益比，这些患者被诊断患有其中一种疾病。本研究有两个主要发现：第一，医疗保健支出可以成为高价值创造的源泉，这种投资应该继续；第二，疾病之间存在显著的价值差异，这凸显了针对特定疾病的支出方法的必要性。
