High-Priced Technology Can Be Good Value for Money

Editorials18 May 1999High-Priced Technology Can Be Good Value for MoneyMilton C. Weinstein, PhDMilton C. Weinstein, PhDHarvard School of Public Health; Boston, MA 02115 (Weinstein)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-10-199905180-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Medical technology is now subject to the same economic scrutiny that was historically reserved for public health and disease prevention programs. It has long been true that vaccination, health education, and screening programs have been required by both public and private health care agencies to prove their economic worth before they could be funded. A frequently encountered criterion for funding of prevention programs is that they must save more money than they spend—the test of “cost savings” (1) or, in a term heard in government circles these days, budget neutrality. As pointed out by Russell (2) and others (3, 4), ...References1. Doubilet P, Weinstein MC, McNeil BJ. Use and misuse of the term “cost effective” in medicine. N Engl J Med. 1986;314:253-6. CrossrefMedlineGoogle Scholar2. Russell LB. Is Prevention Better Than Cure? Washington, DC: Brookings Institution; 1986. Google Scholar3. Hiatt HH, Weinstein MC. Will disease prevention spare the medical commons?. In: Evered D, Whelan J., eds. Ciba Foundation Symposium 100. The Value of Preventive Medicine. London: Pitman; 1985:218-35. Google Scholar4. Weinstein MC. The costs of prevention. J Gen Intern Med. 1990;5 5 Suppl S89-92. CrossrefMedlineGoogle Scholar5. Sisk JE, Riegelman RK. Cost effectiveness of vaccination against pneumococcal pneumonia: an update. Ann Intern Med. 1986;104:79-86. LinkGoogle Scholar6. Edelson JT, Weinstein MC, Tosteson AN, Williams L, Lee TH, Goldman L. Long-term cost-effectiveness of various initial monotherapies for mild to moderate hypertension. JAMA. 1990;263:407-13. CrossrefMedlineGoogle Scholar7. Eddy DM. Screening for breast cancer. Ann Intern Med. 1989;111:389-99. LinkGoogle Scholar8. Eddy DM. Screening for colorectal cancer. Ann Intern Med. 1990;113:373-84. LinkGoogle Scholar9. Eddy DM. Screening for cervical cancer. Ann Intern Med. 1990;113:214-26. LinkGoogle Scholar10. Hornberger JC, Redelmeier DA, Peterson J. Variability among methods to assess patients' well-being and consequent effect on a cost-effectiveness analysis. J Clin Epidemiol. 1992;45:505-12. CrossrefMedlineGoogle Scholar11. Gold MR, Siegel JE, Russell LB, Weinstein MC, eds. Cost-effectiveness in Health and Medicine. New York: Oxford Univ Pr; 1996. Google Scholar12. Rosen AB, Fowler VG, Corey GR, Downs SM, Biddle AK, Li J, et al . Cost-effectiveness of transesophageal echocardiography to determine the duration of therapy for intravascular catheter-associated Staphylococcus aureus bacteremia. Ann Intern Med. 1999;130:810-20. LinkGoogle Scholar13. Gould MK, Dembitzer AD, Sanders GD, Garber AM. Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis. A cost-effectiveness analysis. Ann Intern Med. 1999;130:789-99. LinkGoogle Scholar14. Graham JD, Corso PS, Morris JM, Segui-Gomez M, Weinstein MC. Evaluating the cost-effectiveness of clinical and public health measures. Annu Rev Public Health. 1998;19:125-52. CrossrefMedlineGoogle Scholar15. . An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. The GUSTO investigators. N Engl J Med. 1993;329(10):673-82. Google Scholar16. Mark DB, Hlatky MA, Califf RM, Naylor CD, Lee KL, Armstrong PW, et al . Cost effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction. N Engl J Med. 1995;332:1418-24. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Milton C. Weinstein, PhDAffiliations: Harvard School of Public Health; Boston, MA 02115 (Weinstein)Disclaimer: Dr. Weinstein is the director of the Program on Economic Evaluation of Medical Technology at the Harvard School of Public Health. This program has received unrestricted financial support from several pharmaceutical companies. Dr. Weinstein is also a vice president and consultant of Innovus Research, Inc., a contract research organization specializing in economic evaluations of technologies for the pharmaceutical and medical device industries.Corresponding Author: Milton C. Weinstein, PhD, Department of Health Policy and Management, Harvard School of Public Health, 718 Huntington Avenue, Boston, MA 02115. 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Fox, MD and Richard I. Levin, MD 18 May 1999Volume 130, Issue 10Page: 857-858KeywordsAntibioticsDeep vein thrombosisEndocarditisHealth careHealth economicsHemorrhageLow molecular weight heparinPrevention, policy, and public healthQuality adjusted life yearsTissue plasminogen activator ePublished: 15 August 2000 Issue Published: 18 May 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...