Eldon Spackman

Latest publication from the FoodRx team, led by Dr. Steer: The Impact of Providing Material Benefits to Improve Access to Food in People with Diabetes. Read it here: shorturl.at/djDJ3

Thrilled to share that our team lead, Deborah Marshall, is local co-chair with @aidanhollis for the 16th iHEA World Congress (@healtheconomics). Join us in Calgary July 2025! @UCalgaryMed @UCalgary @IHE_Canada

@frasertingle What?!? You promised me millions.

👉 New piece in @TheLancetEndo - We found the experience of homelessness is associated with mortality among people with diabetes who use hospital services ➡️ 1.45x higher hazard of all-cause mortality and 1.25x higher hazard of cardiovascular specific mortality

The International Health Economics Association (IHEA) is pleased to announce that Calgary, Alberta, has been selected as the location for the IHEA Congress 2025 to be hosted by the University of Calgary and the Institute of Health Economics (IHE).

@shafer_soc Maybe his brand is hyperbole

@mikepaulden @Basucally @djvanness I think this is a really good point. Preferences don’t actually matter. There is a change in health due to a change in supply of health. Whether beneficiaries or payers really understand the consequences or not.

@Basucally @djvanness @eldon_spackman I don't think patients *or* health plans know exactly how much health will be forgone when individuals drop out of coverage. Even an approximate estimate requires detailed research such as that by @djvanness et al.

Focusing on QALYs does not mean it is automatically a health care perspective threshold (i.e.k). Here are the reasons why the threshold identified in this paper is nothing but a demand side threshold (I.e. v).. (1/)

@Basucally @djvanness Isn't it the payers preferences that we care about? They determine if a new treatment is covered. It is their preference between new tx and the number of beneficiaries that they are going to lose. From the payers perspective the # they lose is a probability.

@djvanness @eldon_spackman But the tradeoff between the that price increase and the QALYs forgone is determined by the beneficiaries’ pref This is not unlike any other instance in the market where price increases due to some reason and you study the affect of that increase on those who forgo the product.

@Basucally @djvanness I agree that their decision takes into account their own budget constraint. I think I am assuming that to estimate their WTP you have to know the beneficiaries expenditures, but I think Dave's comment addresses my concern.

@eldon_spackman @djvanness Why not? Do you mean to say their choice of not enrolling in the health plan due to the increase in premium does not account for their own budget constraints? Take a look at hedonic pricing literature..

@Basucally @djvanness A true demand side threshold would estimate their WTP. Here their WTP affects their decision but is not estimated.

@eldon_spackman @djvanness Again, no supply side agents are making the decision to drop health care coverage for the newly uninsured. It is the beneficiaries’ choice in a private market, perfect or not.

@Basucally For this to be a demand supply threshold we would want to look at individual's annual expenditures compared to their own expected health rather than the insurance companies expenditures compared to the groups health.

@Basucally I also agree that the insurers decision affects more than those that decided to forego HI, but I don't think that is a seperate issue.

Everyone is kind of freaking out right now, so I think I will start a thread of quotes from Republicans saying that the election will be fair, votes will be counted, and the person with the most votes will be the next president (a thread)

@Basucally @JamesLomas88 Can you link the paper? I am not sure which one you are talking about.

@eldon_spackman @JamesLomas88 No because your objective function is just QALYs but you have made an assessment of its value through your omnibus budget constraint that includes available resources include the potential effect of health on productivity. See my JHE paper for a formal discussion of this.

@Basucally Can you explain this statement? “Once you relax health care budget, any concept of supply side threshold goes out the window.”

Once you relax health care budget, any concept of supply side threshold goes out the window. Now you have to think what non health factors are being replaced to change the health care budget... (4/)

@Basucally @JamesLomas88 To make this threshold appropriate to be used in a societal analysis wouldn’t they have had to measure the change in productivity/care giver effects and not just the patients QALYs?

@Basucally @JamesLomas88 Ahh... I think I see what you mean. “the perspective is driven by the budget constraint and not the objective function” I think you are talking about the perspective of the threshold here and not a CEA which would reflect these things on both side of the equation?