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.

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.

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.

scholarly journals Cost-Effectiveness Analysis of the Spanish Renal Replacement Therapy Program

2012 ◽  
Vol 32 (2) ◽  
pp. 192-199 ◽  
Author(s):  
Guillermo Villa ◽  
Lucía Fernández–Ortiz ◽  
Jesús Cuervo ◽  
Pablo Rebollo ◽  
Rafael Selgas ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Markov Chain Model ◽  
Cost Savings ◽  
Quality Adjusted Life Year ◽  
Cost Effectiveness Analysis ◽  
Chain Model ◽  
Therapy Program ◽  
Effectiveness Analysis

♦BackgroundWe undertook a cost-effectiveness analysis of the Spanish Renal Replacement Therapy (RRT) program for end-stage renal disease patients from a societal perspective. The current Spanish situation was compared with several hypothetical scenarios.♦MethodsA Markov chain model was used as a foundation for simulations of the Spanish RRT program in three temporal horizons (5, 10, and 15 years). The current situation (scenario 1) was compared with three different scenarios: increased proportion of overall scheduled (planned) incident patients (scenario 2); constant proportion of overall scheduled incident patients, but increased proportion of scheduled incident patients on peritoneal dialysis (PD), resulting in a lower proportion of scheduled incident patients on hemodialysis (HD) (scenario 3); and increased overall proportion of scheduled incident patients together with increased scheduled incidence of patients on PD (scenario 4).♦ResultsThe incremental cost-effectiveness ratios (ICERs) of scenarios 2, 3, and 4, when compared with scenario 1, were estimated to be, respectively, -€83 150, -€354 977, and -€235 886 per incremental quality-adjusted life year (ΔQALY), evidencing both moderate cost savings and slight effectiveness gains. The net health benefits that would accrue to society were estimated to be, respectively, 0.0045, 0.0211, and 0.0219 ΔQALYs considering a willingness-to-pay threshold of €35 000/ΔQALY.♦ConclusionsScenario 1, the current Spanish situation, was dominated by all the proposed scenarios. Interestingly, scenarios 3 and 4 showed the best results in terms of cost-effectiveness. From a cost-effectiveness perspective, an increase in the overall scheduled incidence of RRT, and particularly that of PD, should be promoted.

Application of Cost-Benefit Analysis to the Health Services and the Special Case of Technologic Innovation

1974 ◽  
Vol 4 (2) ◽  
pp. 325-352 ◽  
Author(s):  
Herbert E. Klarman
Keyword(s):  
Cost Effectiveness ◽  
Public Sector ◽  
Health Services ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effectiveness Analysis ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
The Public ◽  
Effectiveness Analysis

As an economic technique for evaluating specific projects or programs in the public sector, cost-benefit analysis is relatively new. In this paper, the theory and practice of cost-benefit analysis in general are discussed as a basis for considering its role in assessing technology in the health services. A review of the literature on applications of cost-benefit or cost-effectiveness analysis to the health field reveals that few complete studies have been conducted to date. It is suggested that an adequate analysis requires an empirical approach in which costs and benefits are juxtaposed, and in which presumed benefits reflect an ascertained relationship between inputs and outputs. A threefold classification of benefits is commonly employed: direct, indirect, and intangible. Since the latter pose difficulty, cost-effectiveness analysis is often the more practicable procedure. After summarizing some problems in predicting how technologic developments are likely to affect costs and benefits, the method of cost-benefit analysis is applied to developments of health systems technology in two settings-the hospital and automated multiphasic screening. These examples underscore the importance of solving problems of measurement and valuation of a project or program in its concrete setting. Finally, barriers to the performance of sound and systematic analysis are listed, and the political context of decision making in the public sector is emphasized.

QALY-Based Cost-Effectiveness Analysis

2016 ◽  
Author(s):  
Jose Maria Abellan ◽  
Carmen Herrero ◽  
Jose Luis Pinto
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effectiveness Analysis ◽  
Ethical Implications ◽  
Effectiveness Analysis ◽  
Descriptive Validity ◽  
Life Years ◽  
Main Ideas ◽  
The Relationship

This chapter introduces the main ideas about the use of quality-adjusted life years (QALYs) in the evaluation of health policies. It starts by explaining the theoretical underpinnings of the QALY model understood as individual utilities. Afterward, it reviews the empirical evidence about the descriptive validity of the main assumptions supporting the model. Then, it explains the main preference elicitation techniques (visual analog scale, time trade-off, and standard gamble). It also shows the practical psychological problems faced by these techniques, such as the existence of context-dependent preferences. The chapter ends by explaining how QALYs are used in priority setting, in particular, the rules governing resources allocation decisions using QALYs, the ethical implications of these rules, and the relationship between cost-benefit analysis and cost-effectiveness analysis.

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