scholarly journals The integrated care pathway for managing post stroke patients (iCaPPS©) in public primary care Healthcentres in Malaysia: impact on quality adjusted life years (QALYs) and cost effectiveness analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aznida Firzah Abdul Aziz ◽  
Nor Azlin Mohd Nordin ◽  
Amrizal Muhd Nur ◽  
Saperi Sulong ◽  
Syed Mohamed Aljunid
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Integrated Care ◽  
Care Pathway ◽  
Quality Adjusted Life Years ◽  
Stroke Patients ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Integrated Care Pathway ◽  
Quality Adjusted Life

scholarly journals Using QALYs versus DALYs to measure cost-effectiveness: How much does it matter?

2020 ◽  
Vol 36 (2) ◽  
pp. 96-103 ◽  
Author(s):  
Xue Feng ◽  
David D. Kim ◽  
Joshua T. Cohen ◽  
Peter J. Neumann ◽  
Daniel A. Ollendorf
Keyword(s):  
Cost Effectiveness ◽  
Medical Center ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Effectiveness Analysis ◽  
Disability Weights ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Relative Differences ◽  
Quality Adjusted Life

ObjectivesQuality-adjusted life-years (QALYs) and disability-adjusted life-years (DALYs) are commonly used in cost-effectiveness analysis (CEA) to measure health benefits. We sought to quantify and explain differences between QALY- and DALY-based cost-effectiveness ratios, and explore whether using one versus the other would materially affect conclusions about an intervention's cost-effectiveness.MethodsWe identified CEAs using both QALYs and DALYs from the Tufts Medical Center CEA Registry and Global Health CEA Registry, with a supplemental search to ensure comprehensive literature coverage. We calculated absolute and relative differences between the QALY- and DALY-based ratios, and compared ratios to common benchmarks (e.g., 1× gross domestic product per capita). We converted reported costs into US dollars.ResultsAmong eleven published CEAs reporting both QALYs and DALYs, seven focused on pharmaceuticals and infectious disease, and five were conducted in high-income countries. Four studies concluded that the intervention was “dominant” (cost-saving). Among the QALY- and DALY-based ratios reported from the remaining seven studies, absolute differences ranged from approximately $2 to $15,000 per unit of benefit, and relative differences from 6–120 percent, but most differences were modest in comparison with the ratio value itself. The values assigned to utility and disability weights explained most observed differences. In comparison with cost-effectiveness thresholds, conclusions were consistent regardless of the ratio type in ten of eleven cases.ConclusionsOur results suggest that although QALY- and DALY-based ratios for the same intervention can differ, differences tend to be modest and do not materially affect comparisons to common cost-effectiveness thresholds.

The Adoption of Cost-Effectiveness Acceptability Curves in Cost-Utility Analyses

2009 ◽  
Vol 30 (3) ◽  
pp. 314-319 ◽  
Author(s):  
Lisa M. Meckley ◽  
Dan Greenberg ◽  
Joshua T. Cohen ◽  
Peter J. Neumann
Keyword(s):  
Cost Effectiveness ◽  
Medical Center ◽  
Cost Effective ◽  
Cost Utility ◽  
Quality Adjusted Life Years ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Study Methodology ◽  
The Uk ◽  
Quality Adjusted Life

Background. Cost-effectiveness acceptability curves (CEACs) plot the probability that one health intervention is more cost-effective than alternatives, as a function of societal willingness to pay for additional units of health (e.g., life-years or quality-adjusted life-years gained). Objectives. To quantify the adoption of CEACs in published cost-utility analyses (CUAs), and to identify factors associated with CEAC use. Methods. Data from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), a database with detailed information on approximately 1,400 CUAs published in the peer reviewed literature through 2006, was analyzed. The registry includes data on study origin, study methodology, reporting of results, whether CEACs were presented, and a subjective quality score. Univariate and multivariate logistic regression analyses were used to identify factors predicting CEAC use, from their introduction in 1994 through 2006. Results. Approximately 15% of CUAs published since 1994 present a CEAC. The use of CEACs has increased rapidly in recent years, from 2.1% of published CUAs in 2001 to 32.6% in 2006 (P < 0.0001). The most significant predictors of CEAC use were study quality (odds ratio [OR]: 2.26; 95% confidence interval [CI]: 1.80, 2.85), recent publication (OR: 1.99; 95% CI: 1.73, 2.29), and whether studies pertain to the UK (OR: 5.66; 95% CI: 3.67, 8.72) or Sweden (OR: 3.76; 95% CI: 1.67, 8.44). Conclusions. CEAC use is increasing in the published cost-effectiveness literature, especially in UK-based studies.

scholarly journals Cost-Effectiveness Analysis of Adding Daratumumab to Bortezomib, Melphalan, and Prednisone for Untreated Multiple Myeloma

2021 ◽  
Vol 12 ◽  
Author(s):  
Yaohua Cao ◽  
Lina Zhao ◽  
Tiantian Zhang ◽  
Weiling Cao
Keyword(s):  
Multiple Myeloma ◽  
Cost Effectiveness ◽  
Life Time ◽  
Cost Effective ◽  
Base Case ◽  
Quality Adjusted Life Years ◽  
Effectiveness Analysis ◽  
Life Years ◽  
The Cost ◽  
Quality Adjusted Life

Background: To evaluate the cost-effectiveness of adding daratumumab to bortezomib, melphalan, and prednisone for transplant-ineligible newly diagnosed multiple myeloma patients.Methods: A three-state Markov model was developed from the perspective of US payers to simulate the disease development of patient’s life time for daratumumab plus bortezomib, melphalan, and prednisone (D-VMP) and bortezomib, melphalan, and prednisone (VMP) regimens. The primary outputs were total costs, expected life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs).Results: The base case results showed that adding daratumumab to VMP provided an additional 3.00 Lys or 2.03 QALYs, at a cost of $262,526 per LY or $388,364 per QALY. Sensitivity analysis indicated that the results were most sensitive to utility of progression disease of D-VMP regimens, but no matter how these parameters changed, ICERs remained higher than $150,000 per QALY.Conclusion: In the case that the upper limit of willingness to pay threshold was $150,000 per QALY from the perspective of US payers, D-VMP was not a cost-effective regimen compared to VMP.

scholarly journals Cost Recommendations in the Second Edition of Cost-Effectiveness in Health and Medicine: A Review

2018 ◽  
Vol 3 (1) ◽  
pp. 238146831876516 ◽  
Author(s):  
John A. Nyman
Keyword(s):  
Cost Effectiveness ◽  
Medical Decision Making ◽  
Steering Committee ◽  
Cost Effectiveness Analysis ◽  
Medical Decision ◽  
Quality Adjusted Life Years ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Quality Adjusted Life

A 2nd edition of Cost-Effectiveness in Health and Medicine has now been published by a group of medical decision-making experts known collectively as the 2nd Panel. This is a critical review of the recommendations for how to deal with costs in cost-effectiveness analysis, recommendations that are contained in Chapter 8 of that edition, titled “Estimating Costs and Valuations of Non-Health Benefits in Cost-Effectiveness Analysis,” authored primarily but not exclusively by Anirban Basu. This review focuses on the correspondence between the costs in the numerator of the incremental cost-effectiveness ratio (ICER) and what is measured in the denominator of the ICER by the quality-adjusted life years (QALYs). Although it raises a number of issues regarding what is actually being measured in the numerator and denominator of the ICER, it primarily challenges the 2nd Panel’s recommendation that the costs of non-health consumption in any additional years of life generated by the intervention in question be accounted for in the numerator, even though no measures of the benefits are included in the QALYs in the denominator. This review is adapted from a review of the entire 2nd edition that was sent to the 2nd Panel steering committee on January 8, 2016.

scholarly journals Promoting seamless transfer-of-care for stroke patients in primary care: development of the integrated care pathway for post stroke services

2014 ◽  
Vol 14 (S1) ◽  
Author(s):  
Aznida Firzah Abdul Aziz ◽  
Noor Azah Abd Aziz ◽  
Nor Azlin Mohd Nordin ◽  
Saperi Sulong ◽  
Syed Mohamed Aljunid
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Care Pathway ◽  
Stroke Patients ◽  
Transfer Of Care ◽  
Post Stroke ◽  
Stroke Services ◽  
Integrated Care Pathway ◽  
Seamless Transfer ◽  
Care Development

scholarly journals Cost-Effectiveness Analysis (CEA) of Preventive COVID-19 Vaccines by Quality-Adjusted Life Years (QALYs)

2021 ◽  
Author(s):  
Rabnawaz Khan
Keyword(s):  
Cost Effectiveness ◽  
Economic Cost ◽  
Maximum Level ◽  
Cost Effectiveness Analysis ◽  
Quality Adjusted Life Years ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Intensive Approach ◽  
The Cost ◽  
Quality Adjusted Life

Abstract This paper merely presents the dynamic boost of the COVID-19 vaccines. The intensive approach is indicating how the effective COVID-19 vaccine promotes and distributes into various official channels. It enables the exclusive authority to devise a possible way to reduce the economic cost of COVID-19 vaccines and facilitate to a maximum level. The Cost-effectiveness analysis (CEA) method approached with Quality-Adjusted Life Years (QALYs). The key findings are revealing the length of life improves the quality of life of the middle family. The results of QALYs show that Utility Value (UV) by health and the value of statistics in countries in the term of coexistent causation of vaccines. The Pfizer (BNT162b2) and Moderna (mRNA-1273) have instantly created favorable and significant effects probably on many patients, comparatively SARS-CoV-2, AstraZeneca (AZD1222), Russia’s Sputnik (AstraZeneca), and Sinopharm Sinovac Biotech. The opportunity cost provides a valuable benefit in the future.

Lenvatinib versus sorafenib for unresectable hepatocellular carcinoma: a cost–effectiveness analysis

2020 ◽  
Vol 9 (8) ◽  
pp. 553-562
Author(s):  
Hongfu Cai ◽  
Longfeng Zhang ◽  
Na Li ◽  
Bin Zheng ◽  
Maobai Liu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Quality Adjusted Life Years ◽  
Cost Effectiveness Ratio ◽  
Phase 3 ◽  
Sorafenib Treatment ◽  
Life Years ◽  
The Cost ◽  
Quality Adjusted Life

Aim: To investigate the cost–effectiveness of lenvatinib and sorafenib in the treatment of patients with nonresected hepatocellular carcinoma in China. Materials & methods: Markov model was used to simulate the direct medical cost and quality-adjusted life years (QALY) of patients with hepatocellular carcinoma. Clinical data were derived from the Phase 3 randomized clinical trial in a Chinese population. Results: Sorafenib treatment resulted in 1.794 QALYs at a cost of $43,780.73. Lenvatinib treatment resulted in 2.916 QALYs for patients weighing <60 and ≥60 kg at a cost of $57,049.43 and $75,900.36, The incremental cost–effectiveness ratio to the sorafenib treatment group was $11,825.94/QALY and $28,627.12/QALY, respectively. Conclusion: According to WHO’s triple GDP per capita, the use of lenvatinib by providing drugs is a cost-effective strategy.

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