
Obscure Model Puts a Price on Good Health and Drives Down Drug Costs - dsgerard
https://www.wsj.com/articles/obscure-model-puts-a-price-on-good-healthand-drives-down-drug-costs-11572885123?mod=rsswn
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cassowary37
"Obscure Newspaper Discovers 40-year-old Concept Widely Used in Medical
Literature" The concept of QALY goes back to 1976[0] and is a mainstay of
cost-effectiveness literature. Fair to say there has sometimes been resistance
to its application in the US, where we like to pretend that we are equitable
in providing care. But odd that WSJ seems to have just discovered this idea.

[0]
[https://academic.oup.com/heapol/article/21/5/402/578296](https://academic.oup.com/heapol/article/21/5/402/578296)

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arkades
I jumped into this comment thread to say precisely that. It’s absolutely
outrageous how many articles about the healthcare industry basically boil down
to: journalist just discovered simple, old, and public concept known to
everyone even loosely in the field, relates it as a shattering innovation.

I’d say this accounts for about 30% of the healthcare articles that end up on
HN. The other 70% are just garbage.

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cameldrv
The relatively straightforward concept of the model is great for comparing
drugs' relative effectiveness. The ICER number of $150k/QALY is wildly out of
line though and will bankrupt us.

1\. The $150k/QALY covers only the cost of the drug, not the cost of the
physician to prescribe it.

2\. The $150k/QALY pricing is based on the manufacturer's hand-picked
population of patients and indications, which may benefit more from the drug
than the average patient it's actually prescribed for.

3\. U.S. per-capita GDP is $60k. One's person's life being extended by one
year consumes the entire income of 2.5 people.

4\. There is an implicit assumption that drug companies are entitled to be
paid by government, the entire value that their products provide. In normal
competitive markets, there is a producer surplus and a consumer surplus, i.e.
prices are higher than the cost of production, but lower than the value they
deliver.

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makomk
The NHS price cap on drugs here in the UK is somewhere in the low tens of
thousands per QALY. This does drive down drug costs, but also means that some
treatments just aren't available.

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jdietrich
_> This does drive down drug costs, but also means that some treatments just
aren't available._

If you aren't rejecting some treatments, you aren't controlling healthcare
costs. A drug or device must be safe and effective to gain market
authorisation, but the threshold of efficacy is statistical significance
rather than clinical significance. Many drugs and devices on the market are
_almost_ useless - not actually useless, but very nearly so.

The usual examples of controlling care costs are stupendously expensive novel
treatments for rare and serious diseases, but an equally serious problem is
marginally effective or ineffective treatments for common complaints.

[https://en.wikipedia.org/wiki/NHS_treatments_blacklist](https://en.wikipedia.org/wiki/NHS_treatments_blacklist)

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neonate
[http://archive.is/YHefE](http://archive.is/YHefE)

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victor106
Anyone has a non-paywall link to this article?

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neonate
[http://archive.is/YHefE](http://archive.is/YHefE)

