Rethinking cost-effectiveness in the era of zero healthcare spending growth

International Journal for Equity in Health
Ronen Arbel, Dan Greenberg

Abstract

The global economic crisis imposes severe restrictions on healthcare budgets, limiting the coverage of new interventions, even when they are cost-effective. Our objective was to develop a tool that can assist decision-makers in comparing the impact of medical intervention alternatives on the entire target population, under a pre-specified budget constraint. We illustrated the tool by using a target population of 1,000 patients, and a budget constraint of $1,000,000. We compared two intervention alternatives: the current practice that costs $1,000 and adds 0.5 quality-adjusted-life-years (QALYs) per patient and a new technology that costs 100 % more, and provides 20 % more QALYs per patient. We also developed a formula for defining the maximum premium price for a higher-cost/higher-effectiveness intervention that can justify its adoption under a constrained budget. Using the new therapy will add 300 QALYs, compared to 500 QALYS when using the lower-cost, lower-effective intervention, despite a favorable incremental cost-effectiveness ratio (ICER) of $10,000. The maximum price for the higher-efficacy therapy that will preserve the target population outcomes is 20 % higher than the lower-cost therapy. Although an intervention asso...Continue Reading

References

Aug 10, 2000·Medical Decision Making : an International Journal of the Society for Medical Decision Making·R A HirthW G Weissert
Feb 24, 2004·Health Care Management Science·Stephen Birch, Amiram Gafni
May 25, 2004·Medical Decision Making : an International Journal of the Society for Medical Decision Making·David M KentKenneth M Langa
Dec 6, 2005·Social Science & Medicine·Amiram Gafni, Stephen Birch
Dec 28, 2005·Journal of Health Services Research & Policy·Stephen Birch, Amiram Gafni
Oct 28, 2006·PharmacoEconomics·Stephen Birch, Amiram Gafni
Nov 4, 2009·Annals of Internal Medicine·Aaron L NelsonDavid M Kent
Apr 1, 2008·Expert Review of Pharmacoeconomics & Outcomes Research·Scott D Grosse
Jun 25, 2010·Health Economics·J Jaime CaroPeter Kolominsky-Rabas
Nov 15, 2011·The New England Journal of Medicine·Niteesh K ChoudhryUNKNOWN Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) Trial
Mar 30, 2013·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Don HusereauUNKNOWN ISPOR Health Economic Evaluation Publication Guidelines-CHEERS Good Reporting Practices Task Force
Jun 14, 2013·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Joran LokkerbolFilip Smit
Jun 26, 2013·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·James D ChambersMartin J Buxton
Jan 21, 2014·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Sean D SullivanWen-Yi Shau
Apr 12, 2014·The New England Journal of Medicine·Channa R JayasekeraMindie H Nguyen
Apr 15, 2014·The New England Journal of Medicine·Jay H Hoofnagle, Averell H Sherker
Aug 28, 2014·The New England Journal of Medicine·Peter J NeumannMilton C Weinstein
Sep 16, 2014·Journal of Viral Hepatitis·H LeleuI Rosa

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Software Mentioned

IQWiG

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.