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This letter critiques a prior cost-effectiveness analysis of sildenafil, arguing that insurers seldom use cost-effectiveness as an explicit criterion for coverage decisions.
This letter critiques a prior cost-effectiveness analysis of sildenafil, arguing that insurers rarely base coverage decisions explicitly on cost-effectiveness thresholds.
Letters6 February 2001Cost-Effectiveness of SildenafilPeter W. Groeneveld, MD and Bradford W. Duncan, MDPeter W. Groeneveld, MDStanford University Center for Health Policy; Stanford, CA 94305-6019 (Groeneveld, Duncan)Search for more papers by this author and Bradford W. Duncan, MDStanford University Center for Health Policy; Stanford, CA 94305-6019 (Groeneveld, Duncan)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-3-200102060-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Smith and Roberts's analysis of sildenafil with interest (1). Medical necessity is a complex issue. The authors framed their study as a clarification of the mechanics of insurer decision making yet provide no evidence that insurers do, in fact, make coverage decisions on the basis of cost-effectiveness thresholds. Cost-effectiveness is seldom used as an explicit criterion in such decisions (2). Thus, the results of this analysis provide little insight into the extent that coverage decisions about sildenafil have been based on cost-effectiveness.Even if insurers did use a cost-effectiveness criterion, the authors' analysis probably overstated ...References1. Smith KJ, Roberts MS. The cost-effectiveness of sildenafil. Ann Intern Med. 2000;132:933-7. LinkGoogle Scholar2. Singer S, Bergthold L, Vorhaus C, Olson S, Mutchnick I, Goh YY, et al . Decreasing Variation in Medical Necessity Decision Making: Final Report to the California HealthCare Foundation. Grant #98- 5021. Stanford, CA: Center for Health Policy, Stanford University; 1999. Google Scholar3. Fryback DG, Dasbach EJ, Klein R, Klein BE, Dorn N, Peterson K, et al . The Beaver Dam Health Outcomes Study: initial catalog of health-state quality factors. Med Decis Making. 1993;13:89-102. CrossrefMedlineGoogle Scholar4. Volk RJ, Cantor SB, Spann SJ, Cass AR, Cardenas MP, Warren MM. Preferences of husbands and wives for prostate cancer screening. Arch Fam Med. 1997;6:72-6. CrossrefMedlineGoogle Scholar5. O'Brien B, Viramontes JL. Willingness to pay: a valid and reliable measure of health state preference? Med Decis Making. 1994;14:289-97. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Peter W. Groeneveld, MD; Bradford W. Duncan, MDAffiliations: Stanford University Center for Health Policy; Stanford, CA 94305-6019 (Groeneveld, Duncan) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Cost-Effectiveness of Sildenafil Kenneth J. Smith and Mark S. Roberts Cost-Effectiveness of Sildenafil Richard L. Siegel and Dale B. Glasser Cost-Effectiveness of Sildenafil Kenneth J. Smith and Mark S. Roberts Cost-Effectiveness of Sildenafil Jack Beaird Metrics 6 February 2001Volume 134, Issue 3Page: 249-250KeywordsDecision analysisDecision makingErectile dysfunction ePublished: 6 February 2001 Issue Published: 6 February 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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Groeneveld et al. (2001) conducted a letter in Erectile dysfunction. Sildenafil was evaluated. This letter critiques a prior cost-effectiveness analysis of sildenafil, arguing that insurers seldom use cost-effectiveness as an explicit criterion for coverage decisions.
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