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Health Aff (Millwood). 2019 Jan;38(1):68-75. doi: 10.1377/hlthaff.2018.05158.

What's Been The Bang For The Buck? Cost-Effectiveness Of Health Care Spending Across Selected Conditions In The US.

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David Wamble ( ) is senior director of health economics at RTI Health Solutions in Durham, North Carolina.
Michael Ciarametaro is vice president of research at the National Pharmaceutical Council, in Washington, D.C.
Katherine Houghton is director of health economics at RTI Health Solutions in Durham.
Mayank Ajmera is a senior research health economist at RTI Health Solutions in Research Triangle Park, North Carolina.
Robert W. Dubois is chief science officer at the National Pharmaceutical Council.


The continued rise in health care spending has led to an intense debate among policy makers and other health care stakeholders on how to best manage increasing costs, leading to a focus on cost increases with little consideration of the associated change in outcomes. We identified the extent to which increased medical intervention spending on seven prevalent chronic conditions in the US over a twenty-year period has been a good investment. The results provide disease-level cost-effectiveness ratios for comparing changes in medical care spending to changes in health outcomes for patients diagnosed with one of the conditions. This study has two key findings: First, dollars spent on medical care can be a source of high value creation, and such investment should continue. Second, significant variability in value exists across diseases, which highlights the need for disease-specific spending approaches.


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