Cost–consequence analysis of public health interventions

2019 ◽  
pp. 233-247
Author(s):  
Ned Hartfiel ◽  
Rhiannon T. Edwards
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Cost Benefit Analysis ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Health Interventions ◽  
Utility Analysis ◽  
Public Health Interventions ◽  
Consequence Analysis ◽  
Cost Consequence

This chapter opens with a discussion around cost–consequence analysis (CCA) and the UK’s NICE recommendation to use CCA in addition to cost–utility analysis for evaluating public health interventions. CCA is sometimes referred to as a disaggregated approach, because the benefits and costs are not combined in a single ratio such as incremental cost-effectiveness ratios (ICERs) in cost–utility analysis. CCA provides a clear descriptive summary for decision-makers that is often easier to interpret than cost-effectiveness, cost–utility, and cost–benefit analysis. The reader or the decision-maker has to form their own opinion concerning the relative importance of costs and outcomes. The chapter offers a case study of CCA by comparing a yoga-based intervention with self-care for managing musculoskeletal conditions in the workplace. The chapter ends with a summary of the principle benefits and major drawbacks of CCA.

Cost–utility analysis of public health interventions

2019 ◽  
pp. 177-203
Author(s):  
Rhiannon T. Edwards ◽  
Eira Winrow
Keyword(s):  
Public Health ◽  
United Kingdom ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Health Interventions ◽  
Utility Analysis ◽  
Public Health Interventions ◽  
The United Kingdom ◽  
Related Quality ◽  
Health Related

This chapter builds upon Chapters 2 and 6 by introducing the reader to the history and concepts of health-related quality of life, cost–utility analysis, quality-adjusted life years (QALYs), and payer thresholds. The aim of this chapter is to outline in more depth the role of applied cost–utility analyses in the economic evaluation of public health interventions. The chapter goes on to reproduce a paper by Owen and colleagues at the National Institute for Health and Care Excellence (NICE) in the United Kingdom. This paper shows that many public health interventions often have a cost per QALY considerably lower than the £20,000 payer threshold conventionally used by NICE in the United Kingdom.

scholarly journals The study of Pharmacoeconomics analysis on anti tuberculosis drugs Rifampicin & Ethambutol

2018 ◽  
Vol 1 (1) ◽  
pp. 31-40
Author(s):  
Arsalan Sarmad ◽  
B. Syed Salman ◽  
Syed Sharfuddin Ibrahim
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit Analysis ◽  
Cost Minimization ◽  
Cost Benefit ◽  
Minimum Cost ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Effective Therapy ◽  
Benefit Analysis ◽  
Utility Analysis

Cost-benefit analysis can be used to quantify the value of clinical pharmacy services. Providing Effective Therapy and Minimum cost, Quantify costs of care, Quantify outcomes, Assess whether and by how much average costs and outcomes differ among treatment groups, Compare magnitude of difference in costs and outcomes and evaluate “value for costs” by reporting a cost-effectiveness ratio, net monetary benefit, or probability that ratio is acceptable – Potential hypothesis: Cost per quality-adjusted life year saved significantly less than Rs.75,000, To Perform sensitivity analysis. For providing good effective therapy with less adverse drug reaction at affordable price, Cost-Identification, Cost-Effectiveness Analysis, Cost-Utility Analysis, Cost-Benefit Analysis, Clinical outcomes: Cure, comfort and survival, Humanistic outcomes: Physical, emotional, social function, role performance, Economic outcomes, Economic Evaluation, Cost of Illness Evaluation (COI), Cost Benefit Analysis (CBA), Cost Minimization Analysis, Cost Effective Analysis: Cost Utility Analysis.

Identifying, measuring, and valuing outcomes within economic evaluations of public health interventions

2019 ◽  
pp. 131-160
Author(s):  
Emma McIntosh
Keyword(s):  
Public Health ◽  
Cost Benefit Analysis ◽  
Public Health Intervention ◽  
Cost Benefit ◽  
Well Being ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Consequence Analysis ◽  
Cost Consequence ◽  
The Many

Chapter 6 explores the many challenges associated with identification, measurement, valuation, reporting, and presenting outcomes within economic evaluations of population health interventions and policies. Drawing on the vast literature in this area, existing guidelines, government recommendations, and methodological advances, this chapter will outline the current challenges, solutions, and suggestions. This chapter also introduces a number of research developments and new outcome measures particularly suited to public health intervention evaluation. These developments include the growing acceptance and relevance of broader measures of outcomes, greater use of ‘capability well-being’ as an outcome, and an increasing use of alternative reporting and presenting frameworks to accommodate these outcomes such as cost–consequence analysis, multi-criteria decision analysis, and social cost–benefit analysis.

scholarly journals Evaluation of a Heart Failure Telemonitoring Program Through a Microsimulation Model: Cost-Utility Analysis

10.2196/18917 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e18917
Author(s):  
Chris Boodoo ◽  
Qi Zhang ◽  
Heather J Ross ◽  
Ana Carolina Alba ◽  
Audrey Laporte ◽  
...  
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Standard Care ◽  
Cost Effective ◽  
Standard Of Care ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Model Parameters ◽  
Microsimulation Model ◽  
Utility Analysis

Background Heart failure (HF) is a major public health issue in Canada that is associated with high prevalence, morbidity, and mortality rates and high financial and social burdens. Telemonitoring (TM) has been shown to improve all-cause mortality and hospitalization rates in patients with HF. The Medly program is a TM intervention integrated as standard of care at a large Canadian academic hospital for ambulatory patients with HF that has been found to improve patient outcomes. However, the cost-effectiveness of the Medly program is yet to be determined. Objective This study aims to conduct a cost-utility analysis of the Medly program compared with the standard of care for HF in Ontario, Canada, from the perspective of the public health care payer. Methods Using a microsimulation model, individual patient data were simulated over a 25-year time horizon to compare the costs and quality-adjusted life years (QALYs) between the Medly program and standard care for patients with HF treated in the ambulatory care setting. Data were sourced from a Medly Program Evaluation study and literature to inform model parameters, such as Medly’s effectiveness in reducing mortality and hospitalizations, health care and intervention costs, and model transition probabilities. Scenario analyses were conducted in relation to HF severity and TM deployment models. One-way deterministic effectiveness analysis and probabilistic sensitivity analysis were performed to explore the impact on the results of uncertainty in model parameters. Results The Medly program was associated with an average total cost of Can $102,508 (US $77,626) per patient and total QALYs of 5.51 per patient compared with the average cost of Can $97,497 (US $73,831) and QALYs of 4.95 per patient in the Standard Care Group. This led to an incremental cost of Can $5011 (US $3794) and incremental QALY of 0.566, resulting in an incremental cost-effectiveness ratio of Can $8850 (US $6701)/QALY. Cost-effectiveness improved in relation to patients with advanced HF and with deployment models in which patients used their own equipment. Baseline and alternative scenarios consistently showed probabilities of cost-effectiveness greater than 85% at a willingness-to-pay threshold of Can $50,000 (US $37,718). Although the results showed some sensitivity to assumptions about effectiveness parameters, the intervention was found to remain cost-effective. Conclusions The Medly program for patients with HF is cost-effective compared with standard care using commonly reported willingness-to-pay thresholds. This study provides evidence for decision makers on the use of TM for HF, supports the use of a nurse-led model of TM that embeds clinically validated algorithms, and informs the use of economic modeling for future evaluations of early-stage health informatics technology.

scholarly journals Evaluation of a Heart Failure Telemonitoring Program Through a Microsimnulation Model: Cost-Utility Analysis (Preprint)

2020 ◽  
Author(s):  
Chris Boodoo ◽  
Qi Zhang ◽  
Heather J Ross ◽  
Ana Carolina Alba ◽  
Audrey Laporte ◽  
...  
Keyword(s):  
Public Health ◽  
Heart Failure ◽  
Cost Effectiveness ◽  
Standard Care ◽  
Cost Effective ◽  
Standard Of Care ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Model Parameters ◽  
Utility Analysis

BACKGROUND Heart failure (HF) is a major public health issue in Canada that is associated with high prevalence, morbidity, and mortality rates and high financial and social burdens. Telemonitoring (TM) has been shown to improve all-cause mortality and hospitalization rates in patients with HF. The <i>Medly</i> program is a TM intervention integrated as standard of care at a large Canadian academic hospital for ambulatory patients with HF that has been found to improve patient outcomes. However, the cost-effectiveness of the <i>Medly</i> program is yet to be determined. OBJECTIVE This study aims to conduct a cost-utility analysis of the <i>Medly</i> program compared with the standard of care for HF in Ontario, Canada, from the perspective of the public health care payer. METHODS Using a microsimulation model, individual patient data were simulated over a 25-year time horizon to compare the costs and quality-adjusted life years (QALYs) between the <i>Medly</i> program and standard care for patients with HF treated in the ambulatory care setting. Data were sourced from a <i>Medly</i> Program Evaluation study and literature to inform model parameters, such as <i>Medly</i>’s effectiveness in reducing mortality and hospitalizations, health care and intervention costs, and model transition probabilities. Scenario analyses were conducted in relation to HF severity and TM deployment models. One-way deterministic effectiveness analysis and probabilistic sensitivity analysis were performed to explore the impact on the results of uncertainty in model parameters. RESULTS The <i>Medly</i> program was associated with an average total cost of Can $102,508 (US $77,626) per patient and total QALYs of 5.51 per patient compared with the average cost of Can $97,497 (US $73,831) and QALYs of 4.95 per patient in the Standard Care Group. This led to an incremental cost of Can $5011 (US $3794) and incremental QALY of 0.566, resulting in an incremental cost-effectiveness ratio of Can $8850 (US $6701)/QALY. Cost-effectiveness improved in relation to patients with advanced HF and with deployment models in which patients used their own equipment. Baseline and alternative scenarios consistently showed probabilities of cost-effectiveness greater than 85% at a willingness-to-pay threshold of Can $50,000 (US $37,718). Although the results showed some sensitivity to assumptions about effectiveness parameters, the intervention was found to remain cost-effective. CONCLUSIONS The <i>Medly</i> program for patients with HF is cost-effective compared with standard care using commonly reported willingness-to-pay thresholds. This study provides evidence for decision makers on the use of TM for HF, supports the use of a nurse-led model of TM that embeds clinically validated algorithms, and informs the use of economic modeling for future evaluations of early-stage health informatics technology.

Cost‐effectiveness in surgery: concepts of cost‐utility analysis explained

2021 ◽  
Author(s):  
Ravi Vissapragada ◽  
Norma Bulamu ◽  
Jonathan Karnon ◽  
Roger Yazbek ◽  
David I. Watson
Keyword(s):  
Cost Effectiveness ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis

scholarly journals Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mireia Massot Mesquida ◽  
Frans Folkvord ◽  
Gemma Seda ◽  
Francisco Lupiáñez-Villanueva ◽  
Pere Torán Monserrat
Keyword(s):  
Cost Effectiveness ◽  
Psychotropic Drugs ◽  
Medication Review ◽  
Standard Care ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Current Standard ◽  
Dementia Patients ◽  
The Cost

Abstract Background Growing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost-effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost-utility of intervention performed in the metropolitan area of Barcelona (Spain) (MN) based on consensus between specialized caregivers involved in the management of dementia patients for optimizing and potentially reducing the prescription of inappropriate psychotropic drugs in this population. This analysis was conducted using the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool. Methods The MAFEIP tool builds up from a variety of surrogate endpoints commonly used across different studies in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs), as well as health and social care utilization. Cost estimates are based on scientific literature and expert opinion; they are direct costs and include medical visits, hospital care, medical tests and exams and drugs administered, among other concepts. The healthcare costs of patients using the intervention were calculated by means of a medication review that compared patients’ drug-related costs before, during and after the use of the intervention conducted in MN between 2012 and 2014. The cost-utility analysis was performed from the perspective of a health care system with a time horizon of 12 months. Results The tool calculated the incremental cost-effectiveness ratio (ICER) of the intervention, revealing it to be dominant, or rather, better (more effective) and cheaper than the current (standard) care. The ICER of the intervention was in the lower right quadrant, making it an intervention that is always accepted even with the lowest given Willingness to Pay (WTP) threshold value (€15,000). Conclusions The results of this study show that the intervention was dominant, or rather, better (more effective) and cheaper than the current (standard) care. This dominant intervention is therefore recommended to interested investors for systematic application.

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