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Essential Elements of a Technology and Outcomes Assessment Initiative
Ezekiel J. Emanuel, MD, PhD;
Victor R. Fuchs, PhD;
Alan M. Garber, MD, PhD
JAMA. 2007;298:1323-1325.
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The mismatch between US health expenditures and the resources devoted to learning which health interventions are most effective is both striking and unwise. Each year US individuals spend more than $2 trillion on health care.1 More than $100 billion is spent for research and development and for regulatory approval of new technologies. Yet total spending on technology assessment almost certainly falls short of $1 billion per year—0.05% of all US health care spending.
Some of the $2 trillion in health care expenditures buys services of little or no value. This waste has been attributed to misleading advertisements, media hype, misguided state and federal mandates, fear of malpractice litigation, misaligned reimbursement incentives, and generous insurance that encourages patients to ignore the cost of services.2-4 Efforts to curb the inappropriate use of medical technologies, however, can have only . . . [Full Text of this Article] Essential Elements of an Effective Medical Technology and Outcomes Assessment Initiative
Author Affiliations: Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland (Dr Emanuel); Department of Economics (Dr Fuchs) and Center for Health Policy (Dr Garber), Stanford University, Palo Alto, California; and VA Palo Alto Health Care System, Palo Alto, California (Dr Garber).
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