Quality-Adjusted Cost Of Care: A Meaningful Way To Measure Growth In Innovation Cost Versus The Value Of Health Gains

摘要

Technology drives both health care spending and health improvement. Yet, policymakers rarely see measures of cost growth that account for both effects. To fill this gap, we present the “quality-adjusted cost of care” (QACC), illustrating cost growth net of growth in the value of health improvements, measured as survival gains multiplied by the value of survival. We apply QACC to two cases. For colorectal cancer, drug cost per patient increased by $35,000 between 1998 and 2005 due to new drug launches, but value from offsetting health improvements netted a modest $1,377 increase in QACC. For multiple myeloma, new therapies increased cost by $72,900 between 2004 and 2009 but offsetting health benefits lowered overall QACC by $67,900. However, myeloma patients on established first-line therapies saw costs rise without corresponding benefits. All three examples document rapid cost growth, but with starkly different implications for whether society “got what it paid for.”