Health Affairs Perspective

Progress In Public-Private Partnerships To Fight Neglected Diseases [Perspective]

Gustavsen, K., Hanson, C. — Mon, 02 Nov 2009 17:03:47 PST

In the global fight against neglected tropical diseases (NTDs), public health partnerships involving donations of medicines by pharmaceutical companies are enabling access to treatment for millions of people worldwide. These partnerships collaborate with other disease programs and a range of key stakeholders to develop and improve programs to control and eliminate NTDs. Although progress is being made against NTDs, continued success depends on a policy environment that supports appropriate levels of engagement and collaboration from all participants.

Expanding The Biopharmaceutical Industry's Involvement In Fighting Neglected Diseases [Perspective]

Geraghty, J. A. — Mon, 02 Nov 2009 17:03:47 PST

The increasingly recognized need for new products for so-called neglected diseases, which afflict large numbers of people but have received relatively little industry investment, presents a clear example of a "strategic" corporate responsibility. Addressing neglected diseases can be important to "health diplomacy" and other national interests as well. Because industrial capabilities are essential to the development of new drugs and vaccines for these diseases, specific policy initiatives to attract more companies to do such work should also be further developed.

Is The United States Ready For QALYs? [Perspective]

Neumann, P. J., Greenberg, D. — Tue, 08 Sep 2009 17:02:05 PDT

Quality-adjusted life-years (QALYs) are used in cost-effectiveness analyses to aid coverage and reimbursement decisions worldwide. QALYs provide a flexible and convenient metric for measuring and comparing health outcomes across diverse diseases and treatments. But their use has stirred controversy about how accurately they reflect preferences for health care and whether their use is fair. We review the debate and the use of QALYs in other countries and discuss prospects for using them in the U.S. health care system. Strict adherence to a QALY approach is likely to prove unacceptable in the United States, but a more flexible use of QALYs could be beneficial.

A Trillion-Dollar Geography Lesson [Perspective]

Baicker, K., Chandra, A. — Tue, 08 Sep 2009 17:02:05 PDT

Dartmouth researchers have demonstrated that there is tremendous geographic variation in the efficiency of health care delivery systems, fostered by perverse incentives that penalize integration, reward fragmentation, and encourage the use of technologies in the "gray areas" of medicine. This research suggests that it is possible to deliver higher-quality care at lower cost. We argue that integrated delivery systems, bundled payments, and more sophisticated comparative effectiveness analysis, rather than crude across-the-board cuts in payments, are the keys to stemming cost growth, improving value, and raising the trillion dollars needed to cover the uninsured.

The Policy On Paying For Treating Hospital-Acquired Conditions: CMS Officials Respond [Perspective]

Straube, B., Blum, J. D. — Tue, 08 Sep 2009 17:02:05 PDT

Policies that decline payment in the event of hospital-acquired conditions have generated considerable public attention. Although the projected payment reductions are not large, small payment penalties have been effective in changing human behavior and ultimately in improving the hospital care experience for patients. Many state Medicaid programs and commercial payers have adopted similar policies. Medicare payment reductions for hospital-acquired conditions are only one component of several efforts to reduce their incidence. The Centers for Medicare and Medicaid Services (CMS) will refine these policies as appropriate. Other CMS strategies to reduce hospital-acquired conditions include public reporting, quality improvement initiatives, value-based purchasing, quality metrics and guidelines development, and national coverage decisions.