Forum Session

Exploring Comparative Effectiveness: Fundamentals and Controversies of Cost-Effectiveness Analysis
October 30, 2008


Michele J. Orza, ScD


Although there is widespread agreement that virtually everyone from the patient to the doctor to the Medicare program itself would benefit from more and better evidence about what works to promote health, even among proponents of an expanded capacity for comparative effectiveness there is major disagreement about how cost-effectiveness fits into the picture, or whether it fits at all.

This session, the fourth in a six-part series intended to lay the foundation for understanding and evaluating existing and anticipated proposals related to comparative effectiveness, focused on the basics of cost-effectiveness analysis, how it relates to comparative effectiveness, and controversies surrounding the use of economic information in coverage and reimbursement decisions. The session began with an introduction to cost-effectiveness analysis and featured a discussion among speakers experienced with cost-effectiveness analysis in both the public and private sectors.


Peter Neumann, ScD, Professor and Director, Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies, Tufts University School of Medicine. Kathleen A. Buto, Vice President for Health Policy, Government Affairs, Johnson & Johnson. Gail Shearer, Director of Health Policy Analysis, and Director, Consumer Reports Best Buy Drugs, Consumers Union. Steven D. Pearson, MD, Founder and President, Institute for Clinical and Economic Review, Massachusetts General Hospital and Harvard Medical School, and Vice-chair, Medicare Evidence Development and Coverage Advisory Committee

Slides from the presentations by Dr. Neumann , Ms. Buto, Ms. Shearer, and Dr. Pearson are available for download. Speakers’ biographies are also available.

Related Materials

For more information on the other sessions in this series, see "Exploring Comparative Effectiveness: Fundamentals of Evidence-Based Health and Introduction to the Cochrane Collaboration" (July 25, 2008); "Exploring Comparative Effectiveness: Activities of NIH, FDA, and AHRQ to Advance Evidence-Based Health" (September 26, 2008); "Exploring Comparative Effectiveness: Activities of CDC, VA, and CMS to Advance Evidence-Based Health" (October 3, 2008); "Exploring Comparative Effectiveness: Options for Expanding U.S. Capacity" (December 17, 2008); and "Exploring Comparative Effectiveness: Lessons from Across the States and Around the World" (February 27, 2009).

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