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Pricing Heart Attack Treatments

In: Medical Care Output and Productivity

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  • David M. Cutler
  • Mark B. McClellan
  • Joseph P. Newhouse
  • Dahlia K. Remler

Abstract

In this paper, we estimate price indices for heart attack treatments, demonstrating the techniques that are currently used in official price indices and presenting some alternatives. We consider two types of price indices, a Service Price Index, which prices specific treatments provided, and a Cost of Living Index, which prices the health outcomes of patients. Both indices are complicated by price measurement issues: list prices and transactions prices are fundamentally different in the medical care field. The development of new or modified medical treatments further complicates the comparison of like' goods over time. And the Cost of Living Index is hampered by the need to determine how much of health improvement results from medical treatments in comparison to other factors. We describe methods to address each of these obstacles. We conclude that whereas traditional price indices when applied to heart attack treatments are rising at roughly 3 percent per year above general inflation, a corrected service price index is rising at perhaps 1 to 2 percent per year above general inflation, and the cost of living index is falling by 1 to 2 percent per year relative to general inflation. We discuss the implications of these results for official price index calculations.
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  • David M. Cutler & Mark B. McClellan & Joseph P. Newhouse & Dahlia K. Remler, 2001. "Pricing Heart Attack Treatments," NBER Chapters, in: Medical Care Output and Productivity, pages 305-362, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberch:7634
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    References listed on IDEAS

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    1. Franklin M. Fisher & Zvi Griliches, 1995. "Aggregate Price Indices, New Goods, and Generics," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 110(1), pages 229-244.
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    5. David M. Cutler & Mark McClellan & Joseph P. Newhouse & Dahlia Remler, 1998. "Are Medical Prices Declining? Evidence from Heart Attack Treatments," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 113(4), pages 991-1024.
    6. Frank, Richard G & Busch, Susan H & Berndt, Ernst R, 1998. "Measuring Prices and Quantities of Treatment for Depression," American Economic Review, American Economic Association, vol. 88(2), pages 106-111, May.
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    Cited by:

    1. Katharine G. Abraham, 2014. "Expanded Measurement of Economic Activity: Progress and Prospects," NBER Chapters, in: Measuring Economic Sustainability and Progress, pages 25-42, National Bureau of Economic Research, Inc.
    2. Joseph P. Newhouse, 2001. "Medical Care Price Indices: Problems and Opportunities / The Chung-Hua Lectures," NBER Working Papers 8168, National Bureau of Economic Research, Inc.
    3. Ralph Kozlow, 2000. "International Accounts Data Needs: Plans, Progress, and Priorities," BEA Papers 0009, Bureau of Economic Analysis.
    4. Adriana Castelli & Peter C Smith, 2006. "Circulatory Disease in the NHS: Measuring Trends in Hospital Costs and Output," Working Papers 021cherp, Centre for Health Economics, University of York.
    5. Jill R. Horwitz, 2005. "Does Corporate Ownership Matter? Service Provision in the Hospital Industry," NBER Working Papers 11376, National Bureau of Economic Research, Inc.
    6. Anne E. Hall, 2015. "Adjusting the Measurement of the Output of the Medical Sector for Quality: A Review of the Literature," BEA Working Papers 0122, Bureau of Economic Analysis.
    7. Jonathan S. Skinner & Elliott S. Fisher & John Wennberg, 2005. "The Efficiency of Medicare," NBER Chapters, in: Analyses in the Economics of Aging, pages 129-160, National Bureau of Economic Research, Inc.
    8. Ernst R. Berndt & David M. Cutler & Richard Frank & Zvi Griliches & Joseph P. Newhouse & Jack E. Triplett, 2001. "Price Indexes for Medical Care Goods and Services -- An Overview of Measurement Issues," NBER Chapters, in: Medical Care Output and Productivity, pages 141-200, National Bureau of Economic Research, Inc.
    9. Diane Dawson & Hugh Gravelle & Mary O'Mahony & Andrew Street & Martin Weale & Adriana Castelli & Rowena Jacobs & Paul Kind & Pete Loveridge & Stephen Martin & Philip Stevens & Lucy Stokes, 2005. "Developing new approaches to measuring NHS outputs and productivity," Working Papers 006cherp, Centre for Health Economics, University of York, revised Dec 2005.
    10. Jill R. Horwitz & Austin Nichols, 2007. "What Do Nonprofits Maximize? Nonprofit Hospital Service Provision and Market Ownership Mix," NBER Working Papers 13246, National Bureau of Economic Research, Inc.
    11. Matthew D. Shapiro & Irving Shapiro & David W. Wilcox, 1999. "Quality Improvement in Health Care: A Framework for Price and Output Measurement," American Economic Review, American Economic Association, vol. 89(2), pages 333-337, May.
    12. Kate Ho & Ariel Pakes & Mark Shepard, 2018. "The Evolution of Health Insurer Costs in Massachusetts, 2010–2012," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 117-137, August.
    13. David E. Lebow & Jeremy B. Rudd, 2003. "Measurement Error in the Consumer Price Index: Where Do We Stand?," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 159-201, March.
    14. Driouchi, Ahmed, 2015. "New Health Technologies and Health Workforce in Developing Economies," MPRA Paper 67775, University Library of Munich, Germany.
    15. David E. Lebow & Jeremy B. Rudd, 2001. "Measurement error in the consumer price index: where do we stand?," Finance and Economics Discussion Series 2001-61, Board of Governors of the Federal Reserve System (U.S.).
    16. Aizcorbe, Ana & Nestoriak, Nicole, 2011. "Changing mix of medical care services: Stylized facts and implications for price indexes," Journal of Health Economics, Elsevier, vol. 30(3), pages 568-574, May.
    17. Andrew Sharpe & Celeste Bradley & Hans Messinger, 2007. "The Measurement of Output and Productivity in the Health Care Sector in Canada: An Overview," CSLS Research Reports 2007-06, Centre for the Study of Living Standards.
    18. Carl A. Johnston & Interdisciplinary Center for Economic Science, 2006. "Agent-based Investigation of Price Inflation In Health Insurance," Computing in Economics and Finance 2006 155, Society for Computational Economics.
    19. Horwitz, Jill R. & Nichols, Austin, 2009. "Hospital ownership and medical services: Market mix, spillover effects, and nonprofit objectives," Journal of Health Economics, Elsevier, vol. 28(5), pages 924-937, September.
    20. Tina Highfill & Elizabeth Bernstein, 2019. "Using disability adjusted life years to value the treatment of thirty chronic conditions in the U.S. from 1987 to 2010: a proof of concept," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 449-466, December.
    21. Marco A. Castaneda & Meryem Saygili, 2021. "The effects of health insurance on the choice of medical procedures: Evidence from heart attacks and childbirths," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(5), pages 1626-1652, September.
    22. Robert J. Gordon, 2000. "The Boskin Commission Report and its Aftermath," NBER Working Papers 7759, National Bureau of Economic Research, Inc.
    23. Dauda, Seidu & Dunn, Abe & Hall, Anne, 2022. "A systematic examination of quality-adjusted price index alternatives for medical care using claims data," Journal of Health Economics, Elsevier, vol. 85(C).

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