Cost effective v. cost saving

Jeff Levin-Scherz nicely demonstrates that cost effective is not the same thing as cost saving, using the example of statins and their decrease in heart disease mortality risk.

Statins are enormously effective drugs that, along with a decrease in cigarette smoking, have been responsible for a huge decrease in the incidence of cardiac death, especially in young men….Simvastatin has been a generic medication for a few years, and atorvastatin (Lipitor) is going generic this coming month. Have we finally reached a point where the use of statins is not merely cost-effective, but is actually cost-saving?

In short, no.

We don’t save money by using even generic statins for primary prevention of heart of vascular disease.   We only gain good health outcomes for a reasonable cost — which doesn’t seem to me to be a bad outcome at all.

We need to learn to ask whether the use of all therapies are worth it, and we also need for the differences between the terms cost effective and cost saving to become more widely known in our culture, and not merely by technical experts. That is part of what it will mean to develop a sustainable health care system–one in which we can look at the benefits and costs rationally, and decide whether what we are doing is worth it.

Update: I had forgotten about this TIE post from Austin ~ 6 weeks back that is relevant.

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