{"id":"https://openalex.org/W2166308264","doi":"https://doi.org/10.1177/0272989x10371134","title":"Does Medicare Have an Implicit Cost-Effectiveness Threshold?","display_name":"Does Medicare Have an Implicit Cost-Effectiveness Threshold?","publication_year":2010,"publication_date":"2010-06-15","ids":{"openalex":"https://openalex.org/W2166308264","doi":"https://doi.org/10.1177/0272989x10371134","mag":"2166308264","pmid":"https://pubmed.ncbi.nlm.nih.gov/20551473"},"language":"en","primary_location":{"id":"doi:10.1177/0272989x10371134","doi":"https://doi.org/10.1177/0272989x10371134","is_oa":false,"landing_page_url":"https://doi.org/10.1177/0272989x10371134","pdf_url":null,"source":{"id":"https://openalex.org/S103359281","display_name":"Medical Decision Making","issn_l":"0272-989X","issn":["0272-989X","1552-681X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-b","doyens","fnege-3","jufo-3","ki-jl-1","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Decision Making","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5079810254","display_name":"James D. Chambers","orcid":"https://orcid.org/0000-0001-5696-4894","observed_orcids":["https://orcid.org/0000-0001-5696-4894"]},"institutions":[{"id":"https://openalex.org/I1290900354","display_name":"Tufts Medical Center","ror":"https://ror.org/002hsbm82","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1290900354"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"James D. Chambers","raw_affiliation_strings":["Health Economics Research Group, Brunel University, Uxbridge, UK, Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, Boston, Massachusetts,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Economics Research Group, Brunel University, Uxbridge, UK, Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, Boston, Massachusetts,","institution_ids":["https://openalex.org/I1290900354"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5009860405","display_name":"Peter J. Neumann","orcid":"https://orcid.org/0000-0003-1226-4073","observed_orcids":["https://orcid.org/0000-0003-1226-4073"]},"institutions":[{"id":"https://openalex.org/I1290900354","display_name":"Tufts Medical Center","ror":"https://ror.org/002hsbm82","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1290900354"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Peter J. Neumann","raw_affiliation_strings":["Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, Boston, Massachusetts"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, Boston, Massachusetts","institution_ids":["https://openalex.org/I1290900354"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5111834002","display_name":"Martin J Buxton","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I59433898","display_name":"Brunel University of London","ror":"https://ror.org/00dn4t376","country_code":"GB","type":"education","lineage":["https://openalex.org/I124357947","https://openalex.org/I59433898"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Martin J. Buxton","raw_affiliation_strings":["Received 21 September 2008 from Health Economics Research Group, Brunel University, Uxbridge, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Received 21 September 2008 from Health Economics Research Group, Brunel University, Uxbridge, UK","institution_ids":["https://openalex.org/I59433898"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":4400,"currency":"USD","value_usd":4400},"apc_paid":null,"fwci":15.8705,"has_fulltext":false,"cited_by_count":63,"citation_normalized_percentile":{"value":0.98729297,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"30","issue":"4","first_page":"E14","last_page":"E27"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.9940999746322632,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.9940999746322632,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.004100000020116568,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/medicare","display_name":"Medicare","score":0.8330000042915344},{"id":"https://openalex.org/keywords/national-coverage-determination","display_name":"national coverage determination","score":0.8240000009536743},{"id":"https://openalex.org/keywords/cost-effectiveness-threshold","display_name":"cost-effectiveness threshold","score":0.8949999809265137},{"id":"https://openalex.org/keywords/centers-for-medicare-medicaid-services","display_name":"Centers for Medicare and Medicaid Services","score":0.9319999814033508},{"id":"https://openalex.org/keywords/incremental-cost-effectiveness-ratio","display_name":"incremental cost-effectiveness ratio","score":0.7559999823570251},{"id":"https://openalex.org/keywords/economic-evaluation","display_name":"economic evaluation","score":0.6520000100135803},{"id":"https://openalex.org/keywords/medical-interventions","display_name":"medical interventions","score":0.5419999957084656},{"id":"https://openalex.org/keywords/health-care-resource-allocation","display_name":"healthcare resource allocation","score":0.5270000100135803}],"concepts":[{"id":"https://openalex.org/C3019080777","wikidata":"https://www.wikidata.org/wiki/Q1754768","display_name":"Cost effectiveness","level":2,"score":0.7572925090789795},{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.6453207731246948},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.6252410411834717},{"id":"https://openalex.org/C2776125615","wikidata":"https://www.wikidata.org/wiki/Q18391886","display_name":"Economic evaluation","level":2,"score":0.5644806623458862},{"id":"https://openalex.org/C2779900020","wikidata":"https://www.wikidata.org/wiki/Q6015473","display_name":"Incremental cost-effectiveness ratio","level":4,"score":0.5601699352264404},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5519419312477112},{"id":"https://openalex.org/C162118730","wikidata":"https://www.wikidata.org/wiki/Q1128453","display_name":"Actuarial science","level":1,"score":0.4840909242630005},{"id":"https://openalex.org/C198531522","wikidata":"https://www.wikidata.org/wiki/Q485146","display_name":"Sample (material)","level":2,"score":0.4607900083065033},{"id":"https://openalex.org/C127454912","wikidata":"https://www.wikidata.org/wiki/Q942582","display_name":"Cost\u2013benefit analysis","level":2,"score":0.4498087167739868},{"id":"https://openalex.org/C64332521","wikidata":"https://www.wikidata.org/wiki/Q614165","display_name":"Quality-adjusted life year","level":3,"score":0.4151197373867035},{"id":"https://openalex.org/C2780033181","wikidata":"https://www.wikidata.org/wiki/Q24962805","display_name":"Decision aids","level":3,"score":0.4117977023124695},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.18557646870613098},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.1658189594745636},{"id":"https://openalex.org/C204787440","wikidata":"https://www.wikidata.org/wiki/Q188504","display_name":"Alternative medicine","level":2,"score":0.14991867542266846},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.13453641533851624},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.10505178570747375},{"id":"https://openalex.org/C185592680","wikidata":"https://www.wikidata.org/wiki/Q2329","display_name":"Chemistry","level":0,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C43617362","wikidata":"https://www.wikidata.org/wiki/Q170050","display_name":"Chromatography","level":1,"score":0.0},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.0},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.0},{"id":"https://openalex.org/C18903297","wikidata":"https://www.wikidata.org/wiki/Q7150","display_name":"Ecology","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D003362","descriptor_name":"Cost-Benefit Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006278","descriptor_name":"Medicare","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.1177/0272989x10371134","doi":"https://doi.org/10.1177/0272989x10371134","is_oa":false,"landing_page_url":"https://doi.org/10.1177/0272989x10371134","pdf_url":null,"source":{"id":"https://openalex.org/S103359281","display_name":"Medical Decision Making","issn_l":"0272-989X","issn":["0272-989X","1552-681X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-b","doyens","fnege-3","jufo-3","ki-jl-1","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Decision Making","raw_type":"journal-article"},{"id":"pmid:20551473","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/20551473","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical decision making : an international journal of the Society for Medical Decision Making","raw_type":"Journal Article"},{"id":"pmh:oai:CiteSeerX.psu:10.1.1.687.9241","doi":null,"is_oa":false,"landing_page_url":"http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.687.9241","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"http://mannen.typepad.com/files/7-16-medicare-cost-effectiveness.pdf","raw_type":"text"},{"id":"pmh:oai:RePEc:sae:medema:v:30:y:2010:i:4:p:e14-e27","doi":null,"is_oa":false,"landing_page_url":"https://journals.sagepub.com/doi/10.1177/0272989X10371134","pdf_url":null,"source":{"id":"https://openalex.org/S4306401271","display_name":"RePEc: Research Papers in Economics","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I77793887","host_organization_name":"Federal Reserve Bank of St. Louis","host_organization_lineage":["https://openalex.org/I77793887"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.4000000059604645}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":56,"referenced_works":["https://openalex.org/W1595046345","https://openalex.org/W1904593211","https://openalex.org/W1970255387","https://openalex.org/W1972533662","https://openalex.org/W1979320641","https://openalex.org/W1981658474","https://openalex.org/W1981854689","https://openalex.org/W1988434973","https://openalex.org/W1988951511","https://openalex.org/W1995517770","https://openalex.org/W1998051333","https://openalex.org/W1998679989","https://openalex.org/W2000325901","https://openalex.org/W2011000634","https://openalex.org/W2015557278","https://openalex.org/W2015770595","https://openalex.org/W2017187764","https://openalex.org/W2021084304","https://openalex.org/W2021110755","https://openalex.org/W2022362859","https://openalex.org/W2023067662","https://openalex.org/W2024838176","https://openalex.org/W2026500950","https://openalex.org/W2029809249","https://openalex.org/W2030546531","https://openalex.org/W2032689844","https://openalex.org/W2033503944","https://openalex.org/W2039796129","https://openalex.org/W2042156822","https://openalex.org/W2044366899","https://openalex.org/W2046436478","https://openalex.org/W2049349947","https://openalex.org/W2058717412","https://openalex.org/W2061306813","https://openalex.org/W2063983068","https://openalex.org/W2068269360","https://openalex.org/W2071387961","https://openalex.org/W2072798283","https://openalex.org/W2075949729","https://openalex.org/W2079205216","https://openalex.org/W2084073221","https://openalex.org/W2093898720","https://openalex.org/W2093975205","https://openalex.org/W2118983774","https://openalex.org/W2122329259","https://openalex.org/W2124057437","https://openalex.org/W2124897393","https://openalex.org/W2130708807","https://openalex.org/W2132743757","https://openalex.org/W2134047636","https://openalex.org/W2158241589","https://openalex.org/W2160714335","https://openalex.org/W2163213830","https://openalex.org/W2340167301","https://openalex.org/W2416726969","https://openalex.org/W2490029776"],"related_works":["https://openalex.org/W7097520626","https://openalex.org/W6980826469","https://openalex.org/W1968904982","https://openalex.org/W2032618387","https://openalex.org/W13822013","https://openalex.org/W2059040254","https://openalex.org/W1986548392","https://openalex.org/W4253730668","https://openalex.org/W1966884056","https://openalex.org/W2427304786"],"abstract_inverted_index":{"BACKGROUND:":[0],"Despite":[1],"the":[2,6,8,86,96,122,134,146,180,215],"huge":[3],"cost":[4],"of":[5,60,85,88,155,179,182,197,232],"program,":[7],"Centers":[9],"for":[10],"Medicare":[11],"and":[12,39,115,141,170],"Medicaid":[13],"Services":[14],"(CMS)":[15],"has":[16,45],"maintained":[17],"a":[18,83,103,111,118,195],"policy":[19],"that":[20,74,132,199,207],"cost-effectiveness":[21,36,61,87,105,152,189,221],"is":[22,193],"not":[23,201],"considered":[24,47,91],"in":[25,48,82,92,225],"national":[26],"coverage":[27,78,98,113],"determinations":[28],"(NCDs).":[29],"OBJECTIVE:":[30],"To":[31],"assess":[32],"whether":[33],"an":[34,129,150,161,173,233],"implicit":[35,234],"threshold":[37],"exists":[38],"to":[40,57,63,101,136,203],"determine":[41],"if":[42],"economic":[43,72,130],"evidence":[44,222,231],"been":[46],"previous":[49],"NCDs.":[50,93],"METHODS:":[51],"A":[52],"literature":[53],"search":[54],"was":[55,80,142,223],"conducted":[56],"identify":[58],"estimates":[59],"relevant":[62],"each":[64,77],"NCD":[65],"from":[66],"1999-2007":[67],"(n":[68],"=":[69],"103).":[70],"The":[71],"evaluation":[73,131],"best":[75],"represented":[76],"decision":[79,114,184],"included":[81],"review":[84],"medical":[89],"interventions":[90,198],"RESULTS:":[94],"Of":[95,121],"64":[97,183],"decisions":[99],"determined":[100],"have":[102],"corresponding":[104],"estimate,":[106],"49":[107],"were":[108,126],"associated":[109,127],"with":[110,117,128,149,160,172],"positive":[112,123],"15":[116],"noncoverage":[119],"decision.":[120],"decisions,":[124],"20":[125],"estimated":[133],"intervention":[135],"be":[137,204,210],"dominant":[138],"(costs":[139],"less":[140,156,167],"more":[143,212],"effective":[144],"than":[145,157,164,168,176],"alternative),":[147],"12":[148],"incremental":[151],"ratio":[153],"(ICER)":[154],"$50,000,":[158],"8":[159],"ICER":[162,174],"greater":[163,175],"$50,000":[165],"but":[166],"$100,000,":[169],"9":[171],"$100,000.":[177],"Fourteen":[178],"sample":[181],"memos":[185],"cited":[186,224],"or":[187],"discussed":[188],"information.":[190],"CONCLUSIONS:":[191],"CMS":[192],"covering":[194],"number":[196],"do":[200],"appear":[202],"cost-effective,":[205],"suggesting":[206],"resources":[208],"could":[209],"allocated":[211],"efficiently.":[213],"Although":[214],"authors":[216],"identified":[217],"several":[218],"instances":[219],"where":[220],"NCDs,":[226],"they":[227],"found":[228],"no":[229],"clear":[230],"threshold.":[235]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":1},{"year":2024,"cited_by_count":1},{"year":2023,"cited_by_count":2},{"year":2022,"cited_by_count":1},{"year":2021,"cited_by_count":4},{"year":2020,"cited_by_count":1},{"year":2018,"cited_by_count":4},{"year":2017,"cited_by_count":1},{"year":2016,"cited_by_count":6},{"year":2015,"cited_by_count":12},{"year":2014,"cited_by_count":5},{"year":2013,"cited_by_count":10},{"year":2012,"cited_by_count":8}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2016-06-24T00:00:00"}
