Research Letter | Health Care Reform

Cost-Effectiveness Decision Making and US Public Opinion

Michael D. Botta, PhD1; Robert J. Blendon, ScD2; John M. Benson, MA3
[+] Author Affiliations
1PhD Program in Health Policy, Harvard University, Cambridge, Massachusetts
2Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts
3Harvard School of Public Health, Boston, Massachusetts
JAMA Intern Med. 2014;174(1):141-143. doi:10.1001/jamainternmed.2013.11332.
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As nations seek to stem the tide of rising health care spending, many have turned to cost-effectiveness research (CER) as a way to reduce spending on low-value interventions. Agencies in the United Kingdom, Italy, Germany, and Australia judge the clinical benefits and costs of new treatments relative to the current standards of care and set explicit thresholds to justify paying for new treatments. In the United States, however, CER is the subject of ongoing political controversy, but little is known about Americans’ attitudes toward government use of CER in decision making. In this article, we present findings from a recently conducted nationwide public survey about CER. We report public opinion on government use of CER and on specific decisions driven by CER using vignettes derived from real-world international decisions.

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