Podcast
Questions and Answers
What is the purpose of the Incremental Cost-effectiveness Ratio (ICER)?
What is the purpose of the Incremental Cost-effectiveness Ratio (ICER)?
What happens if a cost-effectiveness threshold is set too high?
What happens if a cost-effectiveness threshold is set too high?
What does sensitivity analysis allow researchers to estimate?
What does sensitivity analysis allow researchers to estimate?
Which of the following terms describes the value a decision maker is willing to pay for a unit of health gain?
Which of the following terms describes the value a decision maker is willing to pay for a unit of health gain?
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When evaluating health care interventions, why is it important to consider the consequences of accepting or not accepting an intervention?
When evaluating health care interventions, why is it important to consider the consequences of accepting or not accepting an intervention?
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What does a cost-effectiveness plane represent in economic evaluations?
What does a cost-effectiveness plane represent in economic evaluations?
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What is a potential outcome of setting a cost-effectiveness threshold too low?
What is a potential outcome of setting a cost-effectiveness threshold too low?
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What is meant by the term 'mean reduction in blood pressure' in the context of population evaluations?
What is meant by the term 'mean reduction in blood pressure' in the context of population evaluations?
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Study Notes
Techniques of Evaluation
- Economic evaluations assess health care programs' costs and benefits.
- A reference text is "Methods for the economic evaluation of health care programs" by Drummond, M.F., M.J. Sculpher, and G.W. Torrance (2005). ISBN-13: 978-0198529453.
Learning Outcomes
- Students will understand methods and techniques for handling economic evaluation results.
- They will grasp cost-effectiveness thresholds.
- Mastery of sensitivity analysis.
- Identifying the strengths of economic evaluations in decision-making.
Decision and Sensitivity Analysis
- A cost-effectiveness plane is used to illustrate decision-making based on cost and effectiveness of an intervention compared to a new treatment.
- The plane shows four quadrants (NW, NE, SW, SE) reflecting different scenarios of effectiveness and cost.
- Key examples within these planes are given to show the analysis.
Drug B Example
- The slides present a scenario involving Drug B and its cost-effectiveness position on a graphical plane.
Deciding on Drug B
- To adopt Drug B, questions of affordability (budgetary constraints) and justification (outcomes assessment) should be addressed.
- The decision process isn't binary; it needs a clear acceptance threshold.
Cost-Effectiveness Threshold
- A threshold, where the value a decision-maker is willing to pay for a unit of health gain (e.g., QALY or LYG), is often used to determine the threshold.
- High thresholds may result in inefficient NHS resource use, while low thresholds may prevent the adoption of valuable interventions.
- Examples of thresholds from various countries (e.g., Australia, New Zealand, USA, Netherlands, Canada) are provided.
Justification for Different Thresholds
- Acceptance of a particular intervention depends on more than just a budget.
- Factors like patient population need, intervention features, degree of uncertainty or innovation of treatment, and data source accuracy or validity, are all relevant.
Estimating Cost-Effectiveness Threshold
- Establishing a threshold for incremental cost-effectiveness ratios (ICERs) is a complex process.
- It often involves value judgments on the relative value of health gains.
- Methods like societal surveys can help quantify health gain values.
- Some countries use existing interventions (e.g., coronary bypass grafting) to establish baseline costs per QALY.
Using GDP as the Threshold
- A country can set the threshold based on its GDP per capita.
- This suggests a country's resources are the maximum amount it can reasonably invest in health improvements.
- Intervention costs can then be compared against this threshold to assess their affordability.
ICER Explained
- The incremental cost-effectiveness ratio (ICER) of an intervention is calculated by dividing the difference in costs between alternatives by the difference in outcomes.
- If an intervention's ICER is below the acceptance threshold, it's deemed cost-effective.
Cost-Effectiveness Thresholds in Different Countries
- Different countries have varying values for acceptable cost-effectiveness thresholds.This reflects different healthcare priorities and resources.
Uncertainty in Economic Evaluations
- Every economic evaluation is based on samples or limited data, introducing inherent uncertainty.
- A sensitivity analysis helps assess the range where real value is likely to fall. This process is a measure of that uncertainty.
Additional Notes
- The abbreviations used are consistent across the materials. For example, QALY (quality adjusted life year) and LYG (life-year gained).
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Description
This quiz delves into the methods of economic evaluation in health care programs, focusing on cost-effectiveness analyses and sensitivity analyses. Students will explore key concepts such as cost-effectiveness thresholds and the application of the cost-effectiveness plane in decision-making. Mastery of these techniques is essential for effective health care decision-making.
