Going Below the Surface E-Newsletter: March 2019
March 20, 2019
This month, we dig deeper on two things we never seem to have enough of: time and high-quality data. We know that some of these conversations might spark some fierce debates, but we welcome dialogue on health care spending. It’s important to have difficult conversations so that we can find common ground on solutions. Drop us a line or tweet using #GoingBelowTheSurface.
When we talk about health care resources, it’s usually in terms of money or expenditures. But there’s another important resource that we haven’t addressed in this space before, and that’s time. For patients facing terminal diagnoses, time is a precious resource. Two studies (see here and here) and an editorial in JAMA Oncology explore why physicians should discuss important time-related topics with patients sooner, without causing harm, and with potential benefit. The studies found that in the field of oncology, these conversations significantly decreased the rates of anxiety and depression symptoms experienced among patients. These discussions may also have a positive impact on a patient’s care and the trajectory of the illness.
Why It Matters: Patients want to have these difficult conversations with their physicians and can benefit from them. The studies found that while these discussions were useful, physicians still have work to do in making sure that treatment plans mesh with patient goals and peacefulness.
What we spend on health care is important, but how we spend our time matters, too.
All research data have limitations, and failing to pay heed to those limitations can not only mislead or confuse, but – even worse – send policymakers chasing the wrong solution. A case in point: the January Health Affairs paper by Inmaculada Hernandez et al. that attempted to assess what drives the cost of pharmaceuticals, but used only list prices.
In a response in Health Affairs this month, NPC Chief Science Officer Robert W. Dubois, MD, PhD, takes a closer look at the potentially far-reaching conclusions drawn from the study’s narrow analysis.
Dubois’ takeaway message: “Researchers must be careful not to extend their analysis or the implications they draw from it beyond the limits of their data.”
Why it Matters: Today’s environment requires thoughtful consideration into the way that we evaluate and communicate research. Going beyond the questions that we ask in our analyses of data runs the risk of misinforming the conversation around drug prices – and, more broadly, health spending. More importantly, it’s also a time when we must engage in sometimes difficult dialogues around research methods and outcomes. In response to Dr. Dubois’ rebuttal, original author Hernandez shared her thoughts on the limitations and critiques of her analyses. Disagreements in research will always exist, but so do solutions, and that’s what Going Below The Surface is all about.
It was hard to choose just a handful of articles this month, as there were a number that took a deeper dive on the drivers of health care spending in the commercial sectors and public programs like Medicare, whether we should consider “rationing” a dirty word, and how we value curative therapies. If the articles below can’t quench your thirst on this topic, then we recommend checking out Health Affairs’ Considering Health Spending series, featuring provocative dialogues on health spending. (Note: the series is supported by NPC and Anthem, Inc.)