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May 15, 2018

Adding Cost-effectiveness to Define Low-Value Care

Author Affiliations
  • 1Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
JAMA. 2018;319(19):1977-1978. doi:10.1001/jama.2018.2856

Reducing low-value health care is a universally shared goal in virtually all health care systems. However, the task of reducing low-value health care in practice has been hindered by the lack of consensus around a single definition for “value.”

A key area of disagreement among commonly used definitions of value is whether to include economic costs. If costs are excluded, then the value is no different from clinical effectiveness. But if costs are explicitly included in the value, then it is necessary to know how to weigh health care outcomes against costs to determine the overall value. Cost-effectiveness analysis is specifically designed to weigh trade-offs between health outcomes and costs, and can be used to supplement efforts in reducing low-value health care.