In U.S. health policy, low-value care is typically defined by services that both increase costs and do not show significant clinical benefit. However, many services improve health but are not worth their incremental costs. For example, high-priced cancer drugs could improve life expectancy by modest amounts but at large costs. Cost-effectiveness analysis (CEA) uses incremental cost-effectiveness ratios (ICERs) to quantify the tradeoff between health gains versus costs; in the U.S., ICERs >$150,000/quality-adjusted life year (QALY) are typically considered cost-ineffective (i.e., low value). We are using the Tufts CEA Registry to identify low-value health services per cost-effectiveness standards to ask a series of questions, including: 1) what are common features among these types of low-value services? 2) what do clinical guidelines say about these services? and 3) how much money does the U.S. spend on these services?
Dr. Pandya is an Assistant Professor of Health Decision Science in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health.