manatt a u.s. perspective commonwealth fund alliance for health reform november 7, 2011 ian d. spatz
TRANSCRIPT
manatt
A U.S. Perspective
Commonwealth FundAlliance for Health ReformNovember 7, 2011
Ian D. Spatz
Points to make
The U.S. is Different
Search for Value Already Underway in U.S.
Success Depends on Investment in Generating Data, Not Just Analyzing Data
Points to make
The U.S. is Different
Search for Value Already Underway in U.S.
Success Depends on Investment in Generating Data, Not Just Analyzing Data
45.23 liters
24.44 Liters
20.72 Liters
8.96 Liters
Source: 2009 Wine Institute Wine Consumption
45.23 Liters
Source: FAOstat (UN) Beer Consumption
27.36 liters
102.24 Liters102.24 liters
99.83 liters
86.08 liters
Obesity
9.4%
12.9%
23%
30.6%
Source: OECD Health Data 2005Percentage of population with BMI>30
CT Scan Abdomen
$179
$374
$187
$536
Source: International Federation of Health Plans, 2010 (U.S. avg.)
Bypass Surgery
$16,325
$27,327
$13.998
$59,770
Source: International Federation of Health Plans, 2010 (U.S. avg.)
Cost Effectiveness
Cost Effectiveness
Comparative Effectiveness
Cost Effectiveness
Comparative Effectiveness
Patient-Centered Outcome Research
Points to make
The U.S. is Different
Search for Value Already Underway in U.S.
Success Depends on Investment in Generating Data, Not Just Analyzing Data
Large, Empowered Payers
Express Scripts
CVS/Caremark
Germany
France
Medco
UK
MedImpact
90 million
85.1 million
81.5 million
65 million
65 million
63 million
32 million
Atlantic Information Services, 2010
Multi-tier formularies
Generic substitution
Prior authorization
Generics first
Drug utilization review
Risk sharing
Points to make
The U.S. is Different
Search for Value Already Underway in U.S.
Success Depends on Investment in Generating Data, Not Just Analyzing Data
“Whether the addition of [product] to chemotherapy regimens for [type of cancer] improves health outcomes has not been established.”
“It was not certain whether [product] provides enough benefit to patients to justify its high cost …, so NICE did not recommend it.”
“We don’t know”
“We know it doesn’t help”
Starting in 2013, Medicare and all private health insurance companies will pay a tax into a trust fund that will support the activities of the Patient-Centered Outcomes Research Institute
Funding is estimated to reach $500 million annually by 2015
Points to make
The U.S. is Different
Search for Value Already Underway in U.S.
Success Depends on Investment in Generating Data, Not Just Analyzing Data
