Is value-based value wasted? Examining value-based insurance designs through the lens of cost-effectiveness.

Today, both in federal budget discussions and for commercial insurers, value-based insurance designs (VBID) are receiving increased attention, particularly for pharmaceuticals. At one time called benefit-based copayments (BBC), the original VBID model called for a shifting of the health plan subsidy away from lowvalue utilization and towards high-value utilization. “The BBC allows the copay to vary by the evidence-based benefit of the medication for the individual patient … For any given drug, patients with a high potential benefit would have lower