Thresholds can be useful to focus the conversation around the value of treatments in healthcare even if stakeholders have different views on what thresholds should be, explained Steve Pearson, MD, MSc, president of the Institute for Clinical and Economic Review.
Thresholds can be useful to focus the conversation around the value of treatments in healthcare even if stakeholders have different views on what thresholds should be, explained Steve Pearson, MD, MSc, president of the Institute for Clinical and Economic Review.
Transcript
What is the importance of utilizing thresholds to judge affordability and value?
Thresholds mean different things to different people. I think the value of a threshold in itself is that it helps focus the conversation. And it does help to, in a sense, put a stake in the sand, to say, 'This is one way of thinking about how much more we should be willing to pay for an added clinical benefit to patients.' You can always let decision makers judge that or themselves.
And in a very pluralistic health system like the US, you might assume that some payers or some health systems, even some consumers or patients, have different thresholds for what they are willing to pay or how they would like to allocate their resources. But having one theshold, in a sense, helps treat, different conditions fairly or similarly across those different conditions. Because intuitively, there's no reason why we should automatically assumed we should pay more for a patient in heart disease than a patient with a neurologic disorder, or vice versa.
So thresholds kind of throw that conversation fairly across all treatment areas. And also if you're looking at drugs or devices or different kinds of changes to the healthcare system, it puts those on the same playing field, as well. So it's not by itself a definitive answer that you just kind of write down and people walk away. But it's a way to stimulate and focus the kinds of conversation about value that we want to have with all stakeholders at the table.
Neurologists Share Tips for Securing Patient Access to Gene Therapies
March 19th 2025Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
EMBARK Data Show Continued Improvements With DMD Gene Therapy
March 19th 2025Data from the EMBARK trial of delandistrogene moxeparvovec in patients with Duchenne muscular dystrophy (DMD) show that benefits in functional outcomes, gene expression, and muscle imaging persist 2 years after receiving the gene therapy.
Read More
How Access to SMA Treatment Varies Globally and by Insurance Type
March 18th 2025Posters presented at the 2025 Muscular Dystrophy Association (MDA) Clinical & Scientific Conference show that therapeutic advances in treating spinal muscular atrophy (SMA) are not uniformly making it into the hands of patients who could benefit.
Read More