Topic
Health policy
How health systems are financed, measured, and governed, explained non-partisanly at the level of mechanisms and trade-offs.
This page collects every article by Dr. Damon Tojjar in this topic. For all topics see browse by topic, and for the source-anchored record see damontojjar.com/record.
Articles in this topic (20)
- Why a Cost-Effectiveness Threshold Is Really an Opportunity-Cost Question
A cost-per-QALY threshold is often read as the price a health system is willing to pay for a year of good-quality life. That reading is incomplete. In a system with...
- When a Payer Says Yes, For Now: Coverage With Evidence Development
Coverage with evidence development is a conditional yes. A payer agrees to fund a promising treatment now, before the evidence is fully mature, on the condition...
- DALY Versus QALY: Two Ways to Measure Health Loss
Disability-adjusted life years (DALYs) and quality-adjusted life years (QALYs) both squeeze the length and the quality of a life into one number, which is why they...
- The Netflix Model for Medicines: How Delinked Subscription Payment Works
Delinked payment means a health system pays a company a fixed sum for access to a medicine instead of paying per unit dispensed. The revenue is separated, or...
- How a QALY Is Calculated and What It Cannot Capture
A quality-adjusted life year, or QALY, is a single number built from two ingredients: how long a person lives and how good that time is judged to be. You take the...
- How Accountable Care Organizations Try to Pay for Health, Not Volume
An Accountable Care Organization, or ACO, is a group of doctors, hospitals, and other clinicians that agrees to be measured against a spending target, called a...
- How Clinical Guidelines Are Written
A clinical guideline is not one expert's opinion written down. It is the output of a structured process: a panel frames precise questions, a team gathers and...
- How Hospitals Get Paid a Fixed Price Per Case: DRGs and Activity-Based Funding
Under a diagnosis-related group system, a hospital is paid one fixed price for a case, set by the patient's diagnosis and procedure category rather than by the...
- How Evidence Becomes Health Policy, and Why Good Evidence Does Not Guarantee Good Policy
Evidence becomes policy in stages, and each stage does a different job. First, individual studies are gathered and synthesized so we can see what the whole body of...
- How ICER Builds a Value Assessment, Beyond the Price
The short answerWhen the Institute for Clinical and Economic Review (ICER) publishes a value assessment of a new drug, the sticker price is the last thing it...
- Paying for a Cure You Can Only Give Once: How Outcomes-Based and Annuity Agreements Work
A one-time gene therapy priced in the millions creates a payment problem that ordinary drug contracts were never built to solve. Managed entry agreements answer it...
- How Severity Weighting Changes What a Health System Will Pay
Severity weighting is the rule that lets a health system pay more for one unit of health when a disease is severe than when it is mild. It works by multiplying the...
- How the WHO Essential Medicines List Is Actually Chosen
The World Health Organization does not pick essential medicines by popularity or by which drugs are newest. An independent expert committee meets every two years,...
- Managed Entry Agreements: Paying for a Drug Before the Evidence Is In
Managed entry agreements let a health system cover an expensive new medicine before the evidence is settled. Financial versions simply cut the price through...
- The Common Rule and How an IRB Decides a Study Can Proceed
In the United States, most research involving people is governed by a single regulation known as the Common Rule, codified at 45 CFR 46 and enforced through...
- The Three Jobs Every Health System's Money Has to Do
Every health system, whatever its politics or income level, asks its money to do three jobs. It has to raise revenue, gather that revenue into pools, and use those...
- What a Plain Language Trial Summary Must Contain
A plain language trial summary is a regulated document, not a press release. Under Regulation (EU) No 536/2014, the European Union's Clinical Trials Regulation, a...
- What Health Technology Assessment Actually Does
Health technology assessment, usually shortened to HTA, is the disciplined process a health system uses to decide whether a new drug, device, test, or procedure is...
- What the EU's Joint Clinical Assessment Is, and What It Does Not Decide
A Joint Clinical Assessment (JCA) is a single, EU-wide scientific review of how well a new medicine works and how safe it is, measured against the treatments...
- External Reference Pricing: How One Country's Drug Price Follows Another's
External reference pricing, sometimes called international reference pricing, is a method for setting a medicine's national price by comparing it to what a defined...