CEVR Value Databases

The Center for the Evaluation of Value and Risk in Health (CEVR) is the home of two unique databases: the Tufts Medical Center Cost Effectiveness Analysis (CEA) Registry and the Tufts Medicare National Coverage Determinations (NCDs) Database.

These databases help measure and communicate the clinical and economic value of health care strategies.

The CEA Registry is a comprehensive database containing detailed information on more than 8,650 standardized cost-effectiveness ratios and more than 11,800 utility weights published in the peer-reviewed literature. It details studies published from 1976 through 2012 and is regularly updated.

These studies estimate health benefits (in terms of quality-adjusted life-years (QALYs)) and incremental costs for a wide range of health and medical interventions, thus offering a means to identify promising opportunities to invest the nation’s health care resources.

The Registry has been used extensively in the following ways:

  • Used or cited in analyses performed by the CBO, the EPA, the FDA, the Institute of Medicine, the Medicare Payment Assessment Commission, and many others;
  • Listed on the National Library of Medicine’s website as an important health economics resource;
  • Cited in the popular press, including Forbes, The New York Times, The Washington Post, and The Boston Globe;
  • As a data source for over 50 peer-reviewed publications by Peter Neumann, ScD and his colleagues

We consider the Registry a public resource to serve the medical community and we regularly post CEA Registry data on our public use website. Please visit us at the CEA Registry.

The Tufts Medical Center Medicare National Coverage Determinations (NCDs) Database describes decisions made by the Centers for Medicare and Medicaid Services (CMS). It contains detailed information on 166 NCDs completed between 1999 and 2012. CMS issues national coverage determinations (NCDs) annually for 10-15 technologies projected to have a major impact on the program.

We record information on over 30 attributes for each decision. This data provides a historical perspective on the NCD process and allows for the identification of trends in different aspects of coverage for different types of technologies. We have leveraged Information in the NCD Database by analyzing CMS decisions and identifying trends in CMS policies, review times, and evidentiary standards for a variety of technologies and procedures. Findings from this database have achieved national recognition and can be found in recent articles.[1,2,3]

Recent work using this database has searched for evidence that CMS decisions are consistent with an implicit cost-effectiveness threshold. This work has also attempted to identify other factors that may influence CMS coverage decisions.[3] Researchers at CEVR have used this data to produce models predictive of favorable coverage.

Through the continued evolution of the database, we are evaluating the differences in evidentiary requirements for various types of technologies, with a focus on medical devices and diagnostics.

1 Neumann PJ, Kamae MS, Palmer JA. Medicare's national coverage decisions for technologies, 1999-2007. Health Aff (Millwood) 2008; 27(6):1620-1631.

2 Chambers JD, Neumann PJ, Buxton MJ. Does Medicare have an implicit cost-effectiveness threshold? Medical Decision Making 2010; 30(4):E14-E27

3Chambers JD, Morris S, Neumann PJ, Buxton MJ. Factors predicting Medicare national coverage: an empirical analysis. Med Care. 2012 Mar;50(3):249-56.