The process of cost-effectiveness analysis in medical decision-making

2018 ◽  
pp. 54-66
Author(s):  
Tony Lockett
Keyword(s):  
Decision Making ◽  
Cost Effectiveness ◽  
Medical Decision Making ◽  
Cost Effectiveness Analysis ◽  
Medical Decision ◽  
Effectiveness Analysis

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 Taking stock of cost-effectiveness analysis of healthcare in China

2019 ◽  
Vol 4 (3) ◽  
pp. e001418 ◽  
Author(s):  
Thomas Butt ◽  
Gordon G Liu ◽  
David D Kim ◽  
Peter J Neumann
Keyword(s):  
Decision Making ◽  
Cost Effectiveness ◽  
English Language ◽  
Mainland China ◽  
Cost Effectiveness Analysis ◽  
Healthcare Decision ◽  
Reporting Practices ◽  
The Past ◽  
Effectiveness Analysis ◽  
Healthcare Decision Making

IntroductionCost-effectiveness analysis (CEA) is playing an increasingly important role in informing healthcare decision-making in China. This study aims to review the published literature on CEA in mainland China and describe its characteristics and evolution. We provide recommendations on the future direction of CEA as a methodology and as a tool to support healthcare decision-making in China.MethodsEnglish-language cost-per-quality-adjusted life-year (QALY) and cost-per-disability-adjusted life-year (DALY) publications relating to mainland China were reviewed using the Tufts Medical Center Cost-Effectiveness Analysis Registry and Global Health Cost-Effectiveness Analysis Registry through 2017. Study features were summarised using descriptive statistics. Changes in study methodology over time were analysed by trend test, and study characteristics influencing the incremental cost-effectiveness ratio (ICER) of cost-per-QALY studies were investigated using logistic regression.Results170 studies were identified reporting CEA for mainland China (cost/QALY=125, cost/DALY=45) since 1998. The number and quality of studies has increased over the past two decades, with significantly more cost-per-QALY studies compared with cost-per-DALY studies (p<0.0001) and more studies with authors affiliated with Chinese institutions (p=0.0002). The average quality score was 5.04 out of 7 for cost-per-QALY and 4.70 for cost-per-DALY studies based on Registry reviewers’ subjective assessment of overall quality (methods, assumptions and reporting practices). The median ICER reported for interventions for oncology patients was higher (US$26 694 per QALY) than the median ICER reported for all interventions (US$11 503 per QALY). Oncology interventions were associated with the likelihood of reporting higher ICERs than the median ICER (p=0.003).ConclusionThe number of English-language published CEA studies relating to China has grown rapidly over the past 20 years. In terms of quality, the China studies compare favourably with international studies, although they remain a small proportion of studies globally.

scholarly journals WHO SHOULD CONDUCT MODELING AND COST-EFFECTIVENESS ANALYSIS?

2014 ◽  
Vol 30 (1) ◽  
pp. 128-129
Author(s):  
Måns Rosén
Keyword(s):  
Decision Making ◽  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Limited Resources ◽  
Effectiveness Analysis ◽  
Ageing Populations

In some countries, reimbursement of drugs is based on cost-effectiveness analysis (CEA), in others not. In times of ageing populations, increasing number of possible interventions, and limited resources, it seems likely that CEA will be more and more important as a basis for decision making.

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