As both a general internist and an economist, David Meltzer, M.D., Ph.D., Associate Professor, Department of Medicine, has a unique perspective on and understanding of the medical profession. This enables him to address a diverse set of issues in health economics. "My research really sits at the interface between health and the social sciences, obviously with a greater focus on economics because that's my training," says Meltzer.

"I work in two main areas, one of which is the theoretical foundations of medical cost-effectiveness analysis. In that area, I've tried to take tools from economic analysis or theory and use them to try to understand better how to evaluate medical technologies."

One question Meltzer has worked to answer is how to account for future costs in patient care. For example, suppose that someone - who would have died if left untreated - is saved by medical intervention today and continues to live for another fifty years. At age 90, that person may suffer an extremely expensive medical condition completely unrelated to the first incident. The question then becomes should the cost of that illness at age 90 be counted as a cost of the life-saving intervention that happened today.

Historically, the cost of the second condition has been excluded when calculating the cost of treating the first. "But logically it should be considered a cost of treating the primary condition, because without the first intervention, the second illness wouldn't have happened," explains Meltzer. "I wrote a paper that used economic theory to address that very issue, and found in fact you do need to count these future costs. Moreover, if you don't take these future conditions into account, you spend too much money on things that extend life and not enough money on things that improve the quality of life. The paper showed that we systematically under-invest in things that are quality of life enhancing if we neglect to take into account these future costs." Another area of Meltzer's research is the development of economic methods to assess the prospective value of research. In the past several years, several economists have attempted to determine the value of the health gains made by the population relative to the amount of money that has been invested in medical research. The findings of these economists have suggested that the returns were indeed worth the investment, leading to the doubling of the NIH budget over the past several years.

"However, while that work addresses the value of research on average, my work asks the more fundamental questions of what the value of additional research is at the margin and how we can assess its value prospectively in evaluating specific projects," Meltzer says. "The main question is, how do we go about making the case that research we want to do is really worthwhile in an economic sense?"

While this assessment is more difficult to do in basic research, in more applied research, which Meltzer theorizes is the most under-invested area of research, it's crucial to be able to make the case that the research is really likely to be valuable. To address this question, Meltzer developed the mathematics underlying the assessment of a research plan's prospective value, and his method has proven useful in obtaining grants.

"The largest research grant I have is a multi-center trial of hospitalists," Meltzer explains. "It was such a large grant that Agency for Healthcare Quality and Research was initially reluctant to invest in it, but we were able to show what the likely value of the research would be. We were able to show them that it had the potential to save such immense amounts of money and such a large number of lives that even if the likelihood of a positive finding was small, the research was a spectacular investment."

FOREFRONT
The Division of the Biological Sciences is proud to announce the appointment of two new Professors and Chairmen for the Departments of Psychiatry and Medicine...

Comer Children's Hospital Dedication
Opening this winter, the University of Chicago Comer Children's Hospital is dedicated to providing the best health care for children, from newborns to young adults, in a family-focused environment...

DISCOVERIES
In the search for genetic insights into a variety of human conditions, evolutionary biologists often focus their research efforts on mutated or dysfunctional genes, assuming that a change or loss of function in the resulting protein...

DEVELOPMENT
Development is on pace to meet a goal of $65 million in FY2005. Midway through the fiscal year, approximately $30 million has been contributed, and the Spark Discovery campaign has raised more than $420 million...

In Memoriam
Lawrence Z. Freedman

UCH Achieving Breakthrough Update
Started in 2004, Achieving Breakthroughs is a major UCH initiative with significant BSD participation and support. BSD faculty can learn more about the initiative in upcoming faculty meetings in early 2005...

Dollars and Sense
The BSD financial highlights for the first five months of fiscal year 2005.

ACADEMIC AFFAIRS
Recent Recruitemnts and Appointments of Biological Sciences Division Faculty

ACCOLADES
Recent Awards and Grants Information for Biological Sciences Division Faculty

More News & Events

Biological Sciences Division
The University of Chicago 5741 S. Maryland Ave, Chicago, IL 60637
773 702 2900    contact@bsd.uchicago.edu