Costs and cost-effectiveness in critical care

2016 ◽  
Author(s):  
David J. Wallace ◽  
Derek C. Angus
Keyword(s):  
Critical Care ◽  
Cost Effectiveness ◽  
Cost Minimization ◽  
Cost Benefit ◽  
Cost Utility ◽  
Cost Effectiveness Analysis ◽  
Policy Implications ◽  
Funding Policy ◽  
Cost Study ◽  
Effectiveness Analysis

Critical care accounts for a large and growing part of national health expenditures. Cost-effectiveness analyses are one way to identify therapies that maximize society’s return on investment. This chapter provides a broad overview of four cost study designs—cost-minimization, cost-benefit, cost-effectiveness, and cost-utility. Cost -effectiveness analysis allows the costs and benefits of different therapies to be directly compared. Within a constrained budget, cost-effectiveness analysis can identify the optimal therapies for funding. Policy informed by cost effectiveness should improve public health. The reader is introduced to the concepts of cost perspective, included costs and cost discounting. We conclude by describing policy implications of cost effectiveness evaluations and highlight their relevance to the Patient-Centered Outcomes Research Institute.

Health Economics of Vaccination and Immunization Practices

2021 ◽  
Author(s):  
Thomas Szucs
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Cost Effectiveness Analysis ◽  
Vaccination Programs ◽  
Effectiveness Analysis ◽  
Wide Range

The economic importance of vaccines lies partly in the burden of disease that can be avoided and partly in the competition for resources between vaccines and other interventions. Decision-makers are increasingly demanding hard economic data as a basis for the allocation of limited healthcare resources. The main types of evaluation available are cost-benefit analysis (best use of allocated resources), cost-effectiveness analysis (a tool that helps policy-makers decide on the overall allocation of resources), and cost-utility analysis (quality-adjusted life year [QALY] which allows for a direct comparison of a wide range of medical interventions). The cost per QALY for a range of vaccinations can be compared in order to plan a vaccination program. Public health vaccines warrant a cost-benefit approach, in order to determine if they are worthwhile, whereas recommended vaccines might be more usefully assessed by cost-effectiveness analysis. Although cost-savings do not necessarily equate with cost-effectiveness, cost-savings are achieved in many vaccination programs.

Ixazomib (IXA), carfilzomib (CAR), elotuzumab (ELO) or daratumumab (DAR) with lenalidomide and dexamethasone (LEN+DEX) versus LEN+DEX only in relapsed/refractory multiple myeloma (R/R MM): A comparative cost-effectiveness analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8043-8043
Author(s):  
Mavis Obeng-Kusi ◽  
Daniel Arku ◽  
Neda Alrawashdh ◽  
Briana Choi ◽  
Nimer S. Alkhatib ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Utility ◽  
Cost Effectiveness Analysis ◽  
The Other ◽  
Sensitivity Analyses ◽  
Treatment Comparison ◽  
Comparative Cost ◽  
Effectiveness Analysis ◽  
Life Years

8043 Background: IXA, CAR, ELO and DARin combination with LEN+DEXhave been found superior in efficacy compared to LEN+DEX in the management of R/R MM. Applying indirect treatment comparisons from a network meta-analysis (NMA), this economic evaluation aimed to estimate the comparative cost-effectiveness and cost-utility of these four triplet regimens in terms of progression-free survival (PFS). Methods: In the absence of direct treatment comparison from a single clinical trial, NMA was used to indirectly estimate the comparative PFS benefit of each regimen. A 2-state Markov model simulating the health outcomes and costs was used to evaluate PFS life years (LY) and quality-adjusted life years (QALY) with the triplet regimens over LEN+DEX and expressed as the incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR). Probability sensitivity analyses were conducted to assess the influence of parameter uncertainty on the model. Results: The NMA revealed that DAR+LEN+DEX was superior to the other triplet therapies, which did not differ statistically amongst them. As detailed in the Table, in our cost-effectiveness analysis, all 4 triplet regimens were associated with increased PFSLY and PFSQALY gained (g) over LEN+DEX at an additional cost. DAR+LEN+DEX emerged the most cost-effective with ICER and ICUR of $667,652/PFSLYg and $813,322/PFSQALYg, respectively. The highest probability of cost-effectiveness occurred at a willingness-to-pay threshold of $1,040,000/QALYg. Conclusions: Our economic analysis shows that all the triplet regimens were more expensive than LEN +DEX only but were also more effective with respect to PFSLY and PFSQALY gained. Relative to the other regimens, the daratumumab regimen was the most cost-effective.[Table: see text]

Wellbeing Cost-effectiveness Analysis and Existing Approaches

2021 ◽  
pp. 279-332
Author(s):  
Paul Frijters ◽  
Christian Krekel
Keyword(s):  
Cost Effectiveness ◽  
Current Practice ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Business Case ◽  
Cost Effectiveness Analysis ◽  
Important Distinction ◽  
Effectiveness Analysis ◽  
Public Resource ◽  
The Individual

The fourth chapter is targeted mainly at readers who wish to quantify how much benefits and costs are generated by future or existing policies and programmes. The chapter compares the authors’ basic methodology for wellbeing cost-effectiveness analysis (CEA) with existing approaches to decide on public resource allocations. The main comparison is with cost-benefit analysis (CBA), but they also compare it with multi-criterion approaches, social rates of return analyses, and business case scenarios or impact assessments. The authors start with a quick reminder of their basic methodology for wellbeing CEA, after which they sketch the current practice of CBA, highlighting the differences in a stylized, non-technical manner. They also sketch the relationship between WELLBYs (wellbeing years) and QALYs (quality-adjusted life-years), deriving a proper translation between the two measures, which will culminate in the important distinction between the individual willingness-to-pay for a WELLBY and the social costs of producing a WELLBY. They then answer some crucial questions as to how more wellbeing knowledge can be incorporated into existing approaches, including the question of the monetization of wellbeing effects for current-practice CBA. Apart from analysts, this chapter is also of interest to academics in the fields of health and wellbeing as it discusses in depth the differences between WELLBYs and QALYs. The discussion on wellbeing approaches from around the world is of importance to all those tasked with embedding wellbeing into their own country’s public-sector systems.

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