Economic Analysis of Nutrition Interventions: Methods, Research, and Policy
The National Institutes of Health (NIH) Office of Dietary Supplements (ODS), the National Center for Complementary and Alternative Medicine (NCCAM), the National Cancer Institute (NCI), and the National Institute of Nursing Research (NINR) sponsored a workshop on Economic Analysis of Nutrition Interventions on February 23-24, 2010, at the Bethesda North Marriott Hotel & Conference Center, Bethesda, Maryland.
In 2008, healthcare expenditures in the U.S. were estimated to be 17% of the gross domestic product (GDP), and these projected expenditures were largely associated with chronic disease. Medicare beneficiaries spent a median of 16% of their incomes on healthcare, and if current trends persist, a family earning $60,000 "gross wage base" will be spending more than 41% of wages on healthcare in 10 years time. Despite the rapid escalation of healthcare costs, research into healthcare economic solutions has not taken center stage. Nutrition is a foundation of preventive medicine in our healthcare system, and it is postulated that better health outcomes can be achieved for dollars spent by ensuring proper nutrition of the population.
Health economic issues in the U.S. healthcare delivery system have gained increased prominence with President Obama's expressed desire to "raise health care's quality and lower its costs." The National Institutes of Health Clinical and Translational Science Award Program has also recognized the importance of "enhancing the adoption of best practices in the community," including assessment of the costs and effectiveness of prevention and treatment strategies. The potential benefits of health economic analysis applied to health policy include: identifying important factors affecting resource allocation in the setting of increasingly complex, uncertainty-laden medical detection and treatment advances; specifying a basis for allocating resources among diseases and in prevention versus detection, versus treatment; reminding decision-makers about the reality of limited resources; and, offering a rational approach to decision-making when resources are limited.
In view of the current interest in health economics and the potential societal benefit of incorporating health economics as a part of translational science, the NIH/ODS hosted this day-and-a-half long workshop to bring together U.S. and international academicians, researchers, policymakers and regulators to address the following key areas and questions specifically as applied to nutrition interventions:
- State of the Science: What are the health economic methods currently used to judge burden of illness, interventions or healthcare policies, and what new research methodologies are available (or are needed, i.e. what are critical knowledge or methodological gaps or barriers?)
- Research Applications: What are the current and planned evidence-based health economic research activities in nutrition at the NIH, CDC, AHRQ, USDA, FDA, CMS, OMAR, etc. and what are the activities in other countries?
- Regulatory and Policy Maker Perspectives: Once these research goals have been met, how can they assist regulatory and policy makers with nutrition policy decision-making?