Perspective and Costing in Cost-Effectiveness Analysis, 1974-2018.

PharmacoEconomics
David D KimPeter J Neumann

Abstract

Our objective was to examine perspective and costing approaches used in cost-effectiveness analyses (CEAs) and the distribution of reported incremental cost-effectiveness ratios (ICERs). We analyzed the Tufts Medical Center's CEA and Global Health CEA registries, containing 6907 cost-per-quality-adjusted-life-year (QALY) and 698 cost-per-disability-adjusted-life-year (DALY) studies published through 2018. We examined how often published CEAs included non-health consequences and their impact on ICERs. We also reviewed 45 country-specific guidelines to examine recommended analytic perspectives. Study authors often mis-specified or did not clearly state the perspective used. After re-classification by registry reviewers, a healthcare sector or payer perspective was most prevalent (74%). CEAs rarely included unrelated medical costs and impacts on non-healthcare sectors. The most common non-health consequence included was productivity loss in the cost-per-QALY studies (12%) and patient transportation in the cost-per-DALY studies (21%). Of 19,946 cost-per-QALY ratios, the median ICER was $US26,000/QALY (interquartile range [IQR] 2900-110,000), and 18% were cost saving and QALY increasing. Of 5572 cost-per-DALY ratios, the median ICER...Continue Reading

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Citations

Jan 23, 2021·ANZ Journal of Surgery·Ravi VissapragadaDavid I Watson
Jun 5, 2021·Health Services Research·Peter J NeumannJoshua T Cohen
Jun 12, 2021·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Scott D Grosse, James M Gudgeon
Jul 30, 2021·PharmacoEconomics·Sean UrwinMatt Sutton
Aug 11, 2021·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Maude LabergeThomas G Poder
Aug 25, 2021·PharmacoEconomics Open·Sydney C YuenT Joseph Mattingly
Nov 14, 2021·Pediatric Research·Sung Wook KimUNKNOWN SHIPS Research Group

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Methods Mentioned

BETA
pharmacotherapy

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