Webinar Series: Perspectives on US Cost-Effectiveness Thresholds

ICER’s annual Visiting Fellows Program focuses on ongoing research to improve health technology assessments and evidence-based medical policy in the United States.

For our 2019 Visiting Fellows Program, we have invited leading health economists from around the world — Karl Claxton, PhD, MSc, from the University of York; Jens Grueger, PhD, from F. Hoffmann-La Roche & University of Washington; Sean Sullivan, PhD, MS, from the University of Washington; and Chris McCabe, PhD, MSc, from the University of Alberta — to share their perspectives about appropriate cost-effectiveness thresholds in the United States.

To build public awareness around this important research, ICER is publishing the following webinar series. We have posted all relevant materials and citations here.


Completed Webinars

Webinar 1: Philosophical approaches to determining a cost-effectiveness threshold in the United States (Webinar Recording | Slidedeck)

  • Moderators: Steve Pearson and Rick Chapman
  • Lead Presentation: Jens Grueger
  • Responders:
    • Sean Sullivan, University of Washington
    • Dave Vanness, Pennsylvania State University
    • Patricia Danzon, University of Pennsylvania

Webinar 2: Willingness to pay as a basis for a cost-effectiveness threshold in the United States: Using per capita GDP and/or individual surveys to determine a specific threshold range (Webinar Recording | Slidedeck)

  • Moderators: Steve Pearson and Rick Chapman
  • Lead Presentation: Chris McCabe
  • Responders:
    • Jens Grueger, F. Hoffmann-La Roche &
      University of Washington
    • David Meltzer, University of Chicago
    • Lou Garrison, University of Washington

Webinar 3: Willingness to pay Part 2: Using past funding decisions, value of a statistical life, and relative risk aversion as the basis for determining a cost-effectiveness threshold in the US (Webinar Recording | Slidedeck)

  • Moderators: Steve Pearson and Rick Chapman
  • Lead Presentation: Sean Sullivan and Chuck Phelps (risk aversion)
  • Responders:
    • Chris McCabe, University of Alberta
    • Jason Wasfy, Massachusetts General Hospital

Webinar 4: Opportunity cost as a basis for a cost-effectiveness threshold in the United States (Webinar Recording | Presentation Slidedeck | Printable Version of Slidedeck )

  • Moderators: Steve Pearson and Rick Chapman
  • Lead Presentation: Karl Claxton
  • Responders:
    • Sean Sullivan, University of Washington
    • Lou Garrison, University of Washington

Webinar 5: Different thresholds, different perspectives? Equity considerations and the choice between health sector versus societal perspectives (Webinar Recording | Slidedeck)

  • Moderator: Rick Chapman
  • Lead Presentation: Steve Pearson
  • Responders:
    • Karl Claxton, University of York
    • Anirban Basu, University of Washington
    • Patricia Danzon, University of Pennsylvania

ICER’s 2019 Visiting Fellows

Karl Claxton, PhD, MSc
University of York 
Karl Claxton is a Professor in the Department of Economics and Related Studies at the University of York. He is also a Senior Research Fellow in the Centre for Health Economics, University of York.  He was a Harkness Fellow at the Harvard School of Public Health and from 1999 until 2007 he held an adjunct appointment at Harvard as an Assistant Professor of Health and Decision Sciences.

Sean Sullivan, PhD, MS
University of Washington 
Sean D. Sullivan is Professor and Dean of the University of Washington School of Pharmacy. In addition to his joint appointment as Professor of Health Services, He also holds adjunct appointments in the School of Medicine, the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center, and at Kaiser Permanente Washington Health Research Institute. His research interests include technology assessment, medical decision-making and economic evaluation of medical technology. He is past president of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and past chair of the Academy of Managed Care Pharmacy (AMCP) executive committee of the Format for Formulary Submissions – the United States evidence-based guidelines for drug formulary decision-making. He served as chair of the Premera Blue Cross Value-Based Formulary Committee.

Jens Grueger, PhD
F. Hoffmann-La Roche & University of Washington
Jens has a long and distinguished career in global market access across several leading biotech and pharmaceutical companies.  He has now stepped away from his industry roles but until recently was Head of Global Pricing and Market Access, F. Hoffmann-La Roche, Switzerland. He currently serves as President Elect of ISPOR—The International Society for Pharmacoeconomic Outcomes Research – and as an Affiliate Professor at the University of Washington.

Chris McCabe,  PhD, MSc
Institute of Health Economics and University of Alberta
Christopher McCabe is CEO of the Institute of Health Economics, and is on faculty at the University of Alberta. He is also a Visiting Professor of Health Economics at the University of Leeds. He has over 25 years experience as an academic health economist in the UK and North America, including contributing to the authorship of both NICE (UK) and CADTH (Canada) guides to the methods of economic evaluation in health technology appraisal. He continues to lead national and international multidisciplinary research collaborations, with a particular interest in precision medicines.


Webinar Series Moderators

Steven D. Pearson, MD, MSc
President, ICER 
Steven D. Pearson is the Founder and President of the Institute for Clinical and Economic Review (ICER), an independent non-profit organization that evaluates the evidence on the value of medical tests, treatments, and delivery system innovations to encourage collaborative efforts to improve patient care and control costs. Prominent among its evidence reports are ICER reviews of new drugs that include full assessments of clinical and cost-effectiveness along with suggested “value-based price benchmarks” to inform policymakers and guide price and coverage negotiation. ICER convenes public hearings to discuss its evidence reports under the auspices of the California Technology Assessment Forum (CTAF) and Comparative Effectiveness Public Advisory Councils (CEPAC) in New England and the Midwest. At these meetings independent groups of evidence experts and public representatives engage with all stakeholders to debate the strength of evidence and provide recommendations on how best to apply the best evidence to clinical practice and coverage policies. Dr. Pearson is a Lecturer in the Department of Population Medicine at Harvard Medical School and also serves as Visiting Scientist in the Department of Bioethics at the National Institutes of Health. His published work includes over 100 articles on quality of care, the role of evidence-based medicine within the health care system, and related clinical, ethical, and organizational policy challenges. His book, No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence, was published by Oxford University Press.

Among his past roles, from 2005-2006 Dr. Pearson served during the Bush Administration as Special Advisor on Technology and Coverage Policy within the Coverage and Analysis Group at the Centers for Medicare and Medicaid Services. Dr. Pearson has also been a Senior Visiting Fellow at England’s National Institute for Health and Care Excellence (NICE), a Board Director of HTAi, the international society of health technology assessment agencies, and the Vice Chair of the Medicare Evidence Development and Coverage Advisory Committee (MedCAC).

Rick Chapman, PhD, MS
Director of Health Economics, ICER 
Rick directs the development of economic evaluations to accompany rigorous reviews of clinical evidence, assessing the potential costs, cost-effectiveness, and budgetary impact of a wide range of diagnostic, prognostic, therapeutic and other clinical interventions.

Before coming to ICER, Rick was a Vice President of Health Economics and Outcomes Research at Avalere Health, directing the design and analysis of economic evaluations and health outcomes studies. Prior to that, Rick Chapman was a principal in the Health Economics and Outcomes Research practice at IMS Consulting Group. He was also the US regional lead for the Retrospective Database Analysis Center of Excellence at IMS, where he was responsible for conducting studies using several types of real world observational data (including medical and pharmacy administrative claims, electronic medical records, laboratory data, and registries). Previously, Rick was a senior director at ValueMedics Research LLC, which IMS acquired in 2007. Prior to joining ValueMedics, he was a research associate at the Center for Risk Analysis at the Harvard School of Public Health. Before his time at the Harvard School of Public Health, Rick conducted research on the practice of transfusion medicine as part of a National Heart, Lung, and Blood Institute Specialized Center of Research at the Center for Blood Research in Boston.

Rick holds a PhD in health policy with a concentration in decision sciences from Harvard University. He also holds an MS in health policy and management from the Harvard School of Public Health, where he investigated the association between quality of care and health-care financing mechanisms.