Cost-Benefit and Cost-Effectiveness Analyses

2015 ◽  
Author(s):  
Peter Hilsenrath
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit

Avalanche Hazard Mitigation Strategies Assessed by Cost Effectiveness Analyses and Cost Benefit Analyses—evidence from Davos, Switzerland

2006 ◽  
Vol 41 (1) ◽  
pp. 113-129 ◽  
Author(s):  
Sven Fuchs ◽  
Magdalena Thöni ◽  
Maria Christina McAlpin ◽  
Urs Gruber ◽  
Michael Bründl
Keyword(s):  
Cost Effectiveness ◽  
Hazard Mitigation ◽  
Cost Benefit ◽  
Mitigation Strategies ◽  
Avalanche Hazard

Abstract T P309: Cost Effectiveness for Intra-arterial Stroke Therapy Achieved with Image-based Selection and not with Type of Device

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Brenda Reese ◽  
Scott Young ◽  
Kevin Stands ◽  
William Hicks ◽  
Jenniffer Mejilla ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Patient Selection ◽  
Cost Benefit ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Stroke Therapy ◽  
Entire Cohort ◽  
Good Outcome ◽  
Procedure Cost ◽  
The Individual

Background: Our aim was to determine if stentriever treatment results in cost effectiveness over Merci thrombectomy and to identify a cost-effective imaging threshold for intra-arterial treatment selection. Methods: With institutional approval, we retrospectively reviewed patients undergoing intra-arterial stroke therapy from March 2011 to March 2013 at our center. We collected the following data: stroke score, occlusion site, baseline Alberta Stroke Program Early CT Score (ASPECTS), device used, reperfusion, hemorrhage, 90-day modified Rankin Score (mRS), and procedure cost. Using published criteria, a quality-adjusted life year (QUALY) value of 0.74 and 0.4 was ascribed to a mRS outcome 2 respectively. Using the procedural mean cost, we calculated an incremental cost efficiency ratio (ICER) for stentriever versus Merci embolectomy and for interventions done for a baseline ASPECTS above and below the following thresholds: > 6, > 7, > 8, and > 9. Using established criteria, we identified a cost effective patient selection if the ICER was positive and less than $50,000/QUALY. Results: Our cohort included 122 patients, 45 treated with Merci in the first year and 78 with stentrievers in year two. Reperfusion occurred in 79% (87% in the stentriever and 64% with Merci groups, p=0.002). The good outcome rate for the entire cohort was 40% (43% good outcomes in the stentriever and 33% in the Merci groups, p=0.21) respectively. Stentriever interventions were not cost effective compared to Merci embolectomy (ICER > $500,000/QUALY). Using baseline ASPECTS > 6 and > 7 as a selection criteria for intervention, the good outcome rate was 42% and 44% respectively but with a negative ICER due to higher costs in treating those with lower scores. For those with an ASPECTS > 8 and > 9, the good outcome rate was 44% and 54% with an ICER of $40,000/QUALY and $24,000/QUALY respectively. Conclusions: At our institution, despite better outcome and reperfusion rates, stentriever interventions are yet to show a cost benefit. Optimizing patient selection by using the ASPECTS scoring system has led to improved clinical outcomes and cost effectiveness. Further prospective study may validate this technique for greater value to the individual patient and the health system at large.

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.

Efficient two-stage sequential arrays of proof of concept studies for pharmaceutical portfolios

2020 ◽  
pp. 096228022095817
Author(s):  
Linchen He ◽  
Linqiu Du ◽  
Zoran Antonijevic ◽  
Martin Posch ◽  
Valeriy R Korostyshevskiy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit ◽  
Cost Effective ◽  
Cost Ratio ◽  
Proof Of Concept ◽  
Type Iii ◽  
Benefit Cost Ratio ◽  
Stage 1 ◽  
Two Stages ◽  
Benefit Cost

Previous work has shown that individual randomized “proof-of-concept” (PoC) studies may be designed to maximize cost-effectiveness, subject to an overall PoC budget constraint. Maximizing cost-effectiveness has also been considered for arrays of simultaneously executed PoC studies. Defining Type III error as the opportunity cost of not performing a PoC study, we evaluate the common pharmaceutical practice of allocating PoC study funds in two stages. Stage 1, or the first wave of PoC studies, screens drugs to identify those to be permitted additional PoC studies in Stage 2. We investigate if this strategy significantly improves efficiency, despite slowing development. We quantify the benefit, cost, benefit-cost ratio, and Type III error given the number of Stage 1 PoC studies. Relative to a single stage PoC strategy, significant cost-effective gains are seen when at least one of the drugs has a low probability of success (10%) and especially when there are either few drugs (2) with a large number of indications allowed per drug (10) or a large portfolio of drugs (4). In these cases, the recommended number of Stage 1 PoC studies ranges from 2 to 4, tracking approximately with an inflection point in the minimization curve of Type III error.

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