What Is Cost-Effectiveness Analysis?

This is a method insurers use to compare the costs and health outcomes of different treatments for the same condition. They use this analysis to decide if a new, more expensive drug or procedure provides enough extra benefit to be worth covering.

Why It Matters

These analyses can directly impact your treatment options. An insurer might deny coverage for a newer treatment if they decide an older, cheaper one is "good enough," even if your doctor prefers the newer option.

How Mira Mace Can Help

If your insurer denies a treatment based on a cost-effectiveness decision, your advocate can help. We can work with your doctor to build a case for medical necessity and file an appeal arguing that the preferred treatment is the best and most effective option for your specific clinical situation.