Pitfalls in Linking Cost Sharing to Value

Abstract

Letters5 February 2008Pitfalls in Linking Cost Sharing to ValueR. Scott Braithwaite, MD, MSc and Allison B. Rosen, MD, MPH, ScDR. Scott Braithwaite, MD, MScFrom Yale University School of Medicine, Veterans Affairs Connecticut Healthcare System, New Haven, CT 06516, and University of Michigan School of Public Health, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI 48109-0429.Search for more papers by this author and Allison B. Rosen, MD, MPH, ScDFrom Yale University School of Medicine, Veterans Affairs Connecticut Healthcare System, New Haven, CT 06516, and University of Michigan School of Public Health, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI 48109-0429.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-3-200802050-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Polsky for highlighting several substantive issues. Reference pricing (that is, paying the price of only the cheapest drug within a class of similarly effective drugs) is only 1 among many ways to link cost sharing to value, and it also only concerns drugs within a particular class. We endorse an approach that is sufficiently flexible to address a broad range of drug and nondrug clinical alternatives.We recognize that cost-sharing decisions may be plagued by accusations of caprice and conflict of interest, and these same concerns motivated our work. We have proposed a more objective ...