scholarly journals A Systematic Review of WTA-WTP Disparity for Dental Interventions and Implications for Cost-Effectiveness Analysis

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 301
Author(s):  
Pedram Sendi ◽  
Arta Ramadani ◽  
Nicola U. Zitzmann ◽  
Michael M. Bornstein
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Health Gain ◽  
Analytical Framework ◽  
Health Condition ◽  
Cost Effectiveness Analysis ◽  
Cochrane Library ◽  
Effectiveness Analysis ◽  
Substantial Risk ◽  
The Impact

Cost-effectiveness analysis is widely adopted as an analytical framework to evaluate whether health care interventions represent value for money, and its use in dentistry is increasing. Traditionally, in cost-effectiveness analysis, one assumes that the decision maker’s maximum willingness to pay (WTP) for health gain is equivalent to his minimum willingness to accept (WTA) monetary compensation for health loss. It has been documented in the literature that losses are weighted higher than equivalent gains, i.e., that WTA exceeds WTP for the same health condition, resulting in a WTA/WTP ratio greater than 1. There is a knowledge gap of published WTA/WTP ratios for dental interventions in the literature. We therefore conducted a (i) systematic review of published WTA-WTP estimates in dentistry (MEDLINE, Web of Science, Cochrane Library, London, UK) and (ii) a patient-level analysis of WTA/WTP ratios of included studies, and (iii) we demonstrate the impact of a WTA-WTP disparity on cost-effectiveness analysis. Out of 55 eligible studies, two studies were included in our review. The WTA/WTP ratio ranged from 2.58 for discontinuing water fluoridation to 5.12 for mandibular implant overdentures, indicating a higher disparity for implant rehabilitations than for dental public health interventions. A WTA-WTP disparity inflates the cost-effectiveness of dental interventions when there is a substantial risk of both lower costs and health outcomes. We therefore recommend that in these cases the results of cost-effectiveness analyses are reported using different WTA/WTP ratios in a sensitivity analysis.

scholarly journals Systematic review of cost-effectiveness analysis of behavior change communication apps: Assessment of key methods

2021 ◽  
Vol 7 ◽  
pp. 205520762110005
Author(s):  
Cynthia Afedi Hazel ◽  
Sheana Bull ◽  
Elizabeth Greenwell ◽  
Maya Bunik ◽  
Jini Puma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Behavior Change ◽  
Quantitative Measure ◽  
Cost Effectiveness Analysis ◽  
Behavior Change Communication ◽  
Change Communication ◽  
Effectiveness Analysis ◽  
Life Years ◽  
The Cost

Objective Evidence backing the effectiveness of mobile health technology is growing, and behavior change communication applications (apps) are fast becoming a useful platform for behavioral health programs. However, data to support the cost-effectiveness of these interventions are limited. Suggestions for overcoming the low output of economic data include addressing the methodological challenges for conducting cost-effectiveness analysis of behavior change app programs. This study is a systematic review of cost-effectiveness analyses of behavior change communication apps and a documentation of the reported challenges for investigating their cost-effectiveness. Materials and methods Four academic databases: Medline (Ovid), CINAHL, EMBASE and Google Scholar, were searched. Eligibility criteria included original articles that use a cost-effectiveness evaluation method, published between 2008 and 2018, and in the English language. Results Out of the 60 potentially eligible studies, 6 used cost-effectiveness analysis method and met the inclusion criteria. Conclusion The evidence to support the cost-effectiveness of behavior change communication apps is insufficient, with all studies reporting significant study challenges for estimating program costs and outcomes. The main challenges included limited or lack of cost data, inappropriate cost measures, difficulty with identifying and quantifying app effectiveness, representing app effects as Quality-adjusted Life Years, and aggregating cost and effects into a single quantitative measure like Incremental Cost Effectiveness Ratio. These challenges highlight the need for comprehensive economic evaluation methods that balance app data quality issues with practical concerns. This would likely improve the usefulness of cost-effectiveness data for decisions on adoption, implementation, scalability, sustainability, and the benefits of broader healthcare investments.

scholarly journals Impact of Socioeconomic Differences on Distributional Cost-effectiveness Analysis

2020 ◽  
Vol 40 (5) ◽  
pp. 606-618
Author(s):  
Fan Yang ◽  
Colin Angus ◽  
Ana Duarte ◽  
Duncan Gillespie ◽  
Simon Walker ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Inequality ◽  
Local Level ◽  
National Level ◽  
Cost Effectiveness Analysis ◽  
Decision Makers ◽  
Socioeconomic Differences ◽  
Screening And Brief Intervention ◽  
Effectiveness Analysis ◽  
The Impact

Public health decision makers value interventions for their effects on overall health and health inequality. Distributional cost-effectiveness analysis (DCEA) incorporates health inequality concerns into economic evaluation by accounting for how parameters, such as effectiveness, differ across population groups. A good understanding of how and when accounting for socioeconomic differences between groups affects the assessment of intervention impacts on overall health and health inequality could inform decision makers where DCEA would add most value. We interrogated 2 DCEA models of smoking and alcohol policies using first national level and then local authority level information on various socioeconomic differences in health and intervention use. Through a series of scenario analyses, we explored the impact of altering these differences on the DCEA results. When all available evidence on socioeconomic differences was incorporated, provision of a smoking cessation service was estimated to increase overall health and increase health inequality, while the screening and brief intervention for alcohol misuse was estimated to increase overall health and reduce inequality. Ignoring all or some socioeconomic differences resulted in minimal change to the estimated impact on overall health in both models; however, there were larger effects on the estimated impact on health inequality. Across the models, there were no clear patterns in how the extent and direction of socioeconomic differences in the inputs translated into the estimated impact on health inequality. Modifying use or coverage of either intervention so that each population group matched the highest level improved the impacts to a greater degree than modifying intervention effectiveness. When local level socioeconomic differences were considered, the magnitude of the impacts was altered; in some cases, the direction of impact on inequality was also altered.

scholarly journals Global stability and cost-effectiveness analysis of COVID-19 considering the impact of the environment: using data from Ghana

2020 ◽  
Vol 140 ◽  
pp. 110103 ◽  
Author(s):  
Joshua Kiddy K. Asamoah ◽  
Mark A. Owusu ◽  
Zhen Jin ◽  
F. T. Oduro ◽  
Afeez Abidemi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Global Stability ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Using Data ◽  
The Impact
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