Are costs considered for guideline development?

[cave76]

Could this be just one reason for the IDSA's Guideline protocol? Duh!

http://www.ncbi.nlm.nih.gov/pubmed/23649494

"OBJECTIVE
To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. DESIGN Qualitative document review.

MAIN OUTCOMES AND MEASURES
Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations."

"CONCLUSIONS AND RELEVANCE
Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions."

[my note: Giving 30 days of doxycycline is certainly less expensive that 30 days of IV.]

[cave76]

Please read the abstract above----- and see if you agree with the poster that said:
"The [IDSA] docs have zero to gain from doing so, even if they own stock in Big Pharma"

Sometimes people misunderstand abstracts. I know that's easy to do.

[cave76]

In case people are confused by mojo's segue onto CD-57, here is the thread:

http://www.medhelp.org/posts/Lyme-Disease/CD-57-and-NK-cells/show/1943925

[mojogal]

I have to agree again with Jackie. We don't like to give such broad generalized opinions like the one made about the CD-57 because of any newbies coming here, looking for help and reading these things which aren't necessarily true but might be your opinion.

It is a fact that the majority of LLMD do use the CD-57 as a sort of marker of how well someone is doing. Burrascano still uses it and the last thing we want to do is to scare off more newbies who are having a tough enough time already, trying to grasp how confusing and hard this illness is.

It's great that you like to research but IMO we should be aware of others before posting everything.

[JackieCalifornia]

Docs didn't get into medicine to save the insurance company money.

When the docs can find a cheaper, equally effective route, they take it.  

The Hippocratic oath says, "First, do no harm."  All docs swear to uphold that standard when they graduate from medical school.  And saving the insurance companies money would not be a good reason to do anything against the patient.

Part of your post above says:  "Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations."

If you read that carefully, you will see that docs considering the costs of a particular course of treatment is a factor, because docs live in the real world too, but it's an unreasonable leap imo to assume that a medical special-focus group like IDSA is basing their decisions largely or solely on costs.  The docs have zero to gain from doing so, even if they own stock in Big Pharma:  it would take a lot of crooked prescribing to move the needle very far on the stock price.

[cave76]

Oops, lest I seem to be saying that IV is better than orals---- not true for everyone but is for some.