We gathered information on the cost-effectiveness of life-saving interventions in the United States from publicly available economic analyses. "Life-saving interventions" were defined as any behavioral and/or technological strategy that reduces the probability of premature death among a specified target population. We defined cost-effectiveness as the net resource costs of an intervention per year of life saved. To improve the comparability of cost-effectiveness ratios arrived at with diverse methods, we established fixed definitional goals and revised published estimates, when necessary and feasible, to meet these goals. The 587 interventions identified ranged from those that save more resources than they cost, to those costing more than 10 billion dollars per year of life saved. Overall, the median intervention costs $42,000 per life-year saved. The median medical intervention cost $19,000/life-year; injury reduction $48,000/life-year; and toxin control $2,800,000/life-year. Cost/life-year ratios and bibliographic references for more than 500 life-saving interventions are provided.

This comprehensive review of QOL data should lead to more consistent use of QOL weights and thus more comparable cost-effectiveness analyses.

No abstract

The authors performed a meta-analysis to derive pooled utilities for HIV/AIDS and to assess the relative importance of study design characteristics in predicting utilities. Twenty-five articles were identified reporting 74 unique utilities elicited from 1956 respondents. The authors used a hierarchical linear model to perform the meta-analysis, with disease stage, elicitation method, respondent type, and the upper-bound and lower-bound labels for the utility scale as the independent variables. Disease stage (P = 0.016) and respondent type (P = 0.014) were significant predictors of utility. Elicitation method was of marginal significance (P = 0. 052). Bounds were not significant. Pooling utilities, the authors estimate a utility of 0.70 for AIDS, 0.82 for symptomatic HIV and 0.94 for asymptomatic HIV when the time tradeoff method is used to elicit utilities from patients and the scale ranges from death to perfect health. The pooled utilities reported here should be of great use to researchers performing cost-utility analyses of interventions for HIV/AIDS.

We found no systematic difference in stroke QOL weights depending on elicitation method or respondents. However, quality of life is sensitive to the bounds of the scale. Because the pooled QOL estimates reported here are based on a comprehensive review of the QOL literature for stroke, they should be of great use to researchers performing cost-utility analyses of interventions designed to prevent or treat stroke, or where stroke is a possible side effect of therapy.