LEC 6 Handling The Results Of Economic Evaluations 1 PDF

Techniques of evaluation Handling the results of economic evaluations (1) Reference Methods for the economic evaluation of health care programs, Drummond, M.F., M.J. Sculpher, and G.W. Torrance, 2005: Oxford university press. ISBN-13: 978- 0198529453 Learning outcomes By the...

Techniques of evaluation Handling the results of economic evaluations (1) Reference Methods for the economic evaluation of health care programs, Drummond, M.F., M.J. Sculpher, and G.W. Torrance, 2005: Oxford university press. ISBN-13: 978- 0198529453 Learning outcomes By the end of this lecture, you would be able to: ◦ Understand ways and techniques to handle the results of economic evaluations ◦ Understand the Cost-effectiveness thresholds threshold ◦ Understand what is sensitivity analysis ◦ Identify the power of economic evaluations to enable decision making Decision and sensitivity Analysis Do you remember the cost effectiveness plane? Think of such case How do we decide on whether to accept Drug B? Can we afford it? ◦ Budget!! Can we justified ? ◦ What are the consequences of accepting/not accepting it? The decision is not black and white unless we draw a line of acceptance  Remember ICER?  Incremental Cost-effectiveness Ratio (ICER); the difference in costs between alternatives divided by the difference in outcomes measured  If the ICER of the new intervention < than the acceptable cost- effectiveness threshold then the treatment should be adopted  Cost-effectiveness threshold is the value a decision maker is willing to pay for a unit of health gained (e.g QALY or LYG) Cost-effectiveness thresholds If the government uses a cost effectiveness threshold that is too high, this will promote inefficient uses of NHS resources. If however, the threshold is too low, then the most valuable interventions will not be adopted and thus this will not make the best use of available resources. E.g. In UK, NHS funds services which cost 3 x GDP per capita (not cost-effective)  (GDP = Gross domestic product) What do you explain here in this graph New service more costly Uncertainty in PE evaluation  Remember All PE evaluations present means or proportions as outcomes e.g. The mean reduction in blood pressure was 10mmHg The mean cost was £8,500 These results are all based on samples If the study was repeated on a different sample we would obtain a slightly different result So!! We need to estimate the boundaries within which the population (real) value is likely to lie (sensitivity analysis)