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Previous Volume 353:1516-1522 October 6, 2005 Number 14 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text Purchase this article Editorial by Goldman, L. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

The Medicare program has been a notable holdout in the global movement toward the use of cost-effectiveness analysis to inform health care decisions. Unlike the reimbursement authorities in Canada and Australia, and in many countries in Europe, Medicare officials do not formally consider cost-effectiveness when determining the coverage of new medical interventions, even as they also confront ever-growing worries about the program's fiscal solvency.^1,2

In this article, we discuss the road ahead for cost-effectiveness analysis in the Medicare program. We examine resistance to its application, opportunities for its use, and ways in which the United States might move beyond its . . . [Full Text of this Article]

Resistance

The Medicare Modernization Act

Private Formulary Management

Comparative-Effectiveness Research

Functional Equivalence

Key Questions about Cost-Effectiveness Analysis

Is the Method Sound?

Will It Save Money?

Will It Harm Innovation?

Will Americans Ever Tolerate Explicit Rationing by Medicare?

Getting From Here to There

Involving Stakeholders

Possible Congressional Action

Value-Based Reimbursement

Lessons from Abroad

Does the United States Need a New Institute?

Conclusions

Source Information

From the Department of Health Policy and Management and the Center for Risk Analysis, Harvard School of Public Health, Boston (P.J.N., M.C.W.); and the Division of General Medicine, University of Michigan Health System, and the Center for Practice Management and Outcomes Research, Ann Arbor Veterans Affairs Medical Center — both in Ann Arbor, Mich. (A.B.R.).

Related Letters:

Medicare and Cost-Effectiveness Analysis
Schulman K. A., Smolkin M. T., Berger M., Honig P., Spatz I., Neumann P. J., Rosen A. B., Weinstein M. C., Goldman L.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:207-209, Jan 12, 2006. Correspondence

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