Contemporary health care economics: an overview

McLaughlin, Nancy; Ong, Michael; Tabbush, Victor; Hagigi, Farhad; Martin, Neil A.

doi:10.3171/2014.8.focus14455

Cited by 10 publications

(5 citation statements)

References 31 publications

(40 reference statements)

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“…It has been widely accepted that economic evaluation, for example, cost-effectiveness analysis (CEA) and cost-utility analysis (CUA), is an important decision-making tool for healthcare resource allocation. 7 Economic evaluation compares costs and benefits between competing technologies as incremental cost-effectiveness ratio (ICER) or incremental cost-utility ratio (ICUR). 8 9 A common measure of trading off between costs and benefits is incremental cost per quality-adjusted life year (QALY) gained.…”

Section: Introductionmentioning

confidence: 99%

Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand

Nimdet

Ngorsuraches

2015

BMJ Open

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ObjectiveTo estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) value for life-saving treatments and to determine factors affecting the WTP per QALY value.DesignA cross-sectional survey with multistage sampling and face-to-face interviews.SettingGeneral population in the southern part of Thailand.ParticipantsA total of 600 individuals were included in the study. Only 554 (92.3%) responses were usable for data analyses.Outcome measureParticipants were asked for the maximum amount of WTP value for life-saving treatments by an open-ended question. EQ-5D-3L and visual analogue scale (VAS) were used to estimate additional QALY.ResultsThe amount of WTP values varied from 0 to 720 000 Baht/year (approximately 32 Baht=US$1). The averages of additional QALY obtained from VAS and EQ-5D-3L were only slightly different (0.872 and 0.853, respectively). The averages of WTP per QALY obtained from VAS and EQ-5D-3L were 244720 and 243120 Baht/QALY, respectively. As compared to male participants, female participants were more likely to pay less for an additional QALY (p=0.007). In addition, participants with higher household incomes tended to have higher WTP per QALY values (p<0.001).ConclusionsOur study added another WTP per QALY value specifically for life-saving treatments, which would complement the current cost-effectiveness threshold used in Thailand and optimise patient access to innovative treatments or technologies.

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Section: Introductionmentioning

confidence: 99%

Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand

Nimdet

Ngorsuraches

2015

BMJ Open

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“…25,26,29,47,49 In our study, the estimated cost-utility ratio was R$30,828. 35 1,2 With respect to nonspine studies, the cost per QALY gained that was observed in the present study can be compared with hip arthroplasty, for which the cost per QALY gained ranges between $29,139 and $80,000. 11 For total knee replacement, the cost per QALY gained has been reported as $59,262.…”

Section: Discussionmentioning

confidence: 77%

“…27 Four main types of analyses are currently used in health care economics: cost-minimization, cost-benefit, cost-effectiveness, and cost-utility. 35 Cost-minimization studies simply describe the costs of treatments for an indication to determine the least expensive. Cost-benefit analyses establish the ratio between resources spent and benefits gained with a determined treatment.…”

mentioning

confidence: 99%

Economic value of treating lumbar disc herniation in Brazil

Falavigna

Scheverin²,

Righesso

et al. 2016

SPI

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OBJECT Lumbar discectomy is one of the most common surgical spine procedures. In order to understand the value of this surgical care, it is important to understand the costs to the health care system and patient for good results. The objective of this study was to evaluate for the first time the cost-effectiveness of spine surgery in Latin America for lumbar discectomy in terms of cost per quality-adjusted life year (QALY) gained for patients in Brazil. METHODS The authors performed a prospective cohort study involving 143 consecutive patients who underwent open discectomy for lumbar disc herniation (LDH). Patient-reported outcomes were assessed utilizing the SF-6D, which is derived from a 12-month variation of the SF-36. Direct medical costs included medical reimbursement, costs of hospital care, and overall resource consumption. Disability losses were considered indirect costs. A 4-year horizon with 3% discounting was applied to health-utilities estimates. Sensitivity analysis was performed by varying utility gain by 20%. The costs were expressed in Reais (R$) and US dollars ($), applying an exchange rate of 2.4:1 (the rate at the time of manuscript preparation). RESULTS The direct and indirect costs of open lumbar discectomy were estimated at an average of R$3426.72 ($1427.80) and R$2027.67 ($844.86), respectively. The mean total cost of treatment was estimated at R$5454.40 ($2272.66) (SD R$2709.17 [$1128.82]). The SF-6D utility gain was 0.044 (95% CI 0.03197–0.05923, p = 0.017) at 12 months. The 4-year discounted QALY gain was 0.176928. The estimated cost-utility ratio was R$30,828.35 ($12,845.14) per QALY gained. The sensitivity analysis showed a range of R$25,690.29 ($10,714.28) to R$38,535.44 ($16,056.43) per QALY gained. CONCLUSIONS The use of open lumbar discectomy to treat LDH is associated with a significant improvement in patient outcomes as measured by the SF-6D. Open lumbar discectomy performed in the Brazilian supplementary health care system provides a cost-utility ratio of R$30,828.35 ($12,845.14) per QALY. The value of acceptable cost-effectiveness will vary by country and region.

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“…All types of economic evaluations were included in the cost analysis, such as cost minimization analysis, cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis [ 17 ]. In addition, we considered partial economic evaluations that did not include the consequences of therapeutic strategies and costs [ 18 , 19 ]. In cases of unclear classification, the 2 researchers discussed differences until an agreement was reached.…”

Section: Methodsmentioning

confidence: 99%

Economic Evaluation of COVID-19 Screening Tests and Surveillance Strategies in Low-Income, Middle-Income, and High-Income Countries: A Systematic Review

Purba,

Rosyid,

Handayani

et al. 2024

Med Sci Monit

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Background Economic evaluation of the testing strategies to control transmission and monitor the severity of COVID-19 after the pandemic is essential. This study aimed to review the economic evaluation of COVID-19 tests and to construct a model with outcomes in terms of cost and test acceptability for surveillance in the post-pandemic period in low-income, middle-income, and high-income countries. Material/Methods We performed the systematic review following PRISMA guidelines through MEDLINE and EMBASE databases. We included the relevant studies that reported the economic evaluation of COVID-19 tests for surveillance. Also, we input current probability, sensitivity, and specificity for COVID-19 surveillance in the post-pandemic period. Results A total of 104 articles met the eligibility criteria, and 8 articles were reviewed and assessed for quality. The specificity and sensitivity of COVID-19 screening tests were reported as 80% to 90% and 40% to 90%, respectively. The target population presented a mortality rate between 0.2% and 19.2% in the post-pandemic period. The implementation model of COVID-19 screening tests for surveillance with a cost mean for molecular and antigen tests was US$ 46.64 (min–max US $0.25–$105.39) and US $6.15 (min–max US $2–$10), respectively. Conclusions For the allocation budget for the COVID-19 surveillance test, it is essential to consider the incidence and mortality of the post-pandemic period in low-income, middle-income, and high-income countries. A robust method to evaluate outcomes is needed to prevent increasing COVID-19 incidents earlier.

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Contemporary health care economics: an overview

Cited by 10 publications

References 31 publications

Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand

Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand

Economic value of treating lumbar disc herniation in Brazil

Economic Evaluation of COVID-19 Screening Tests and Surveillance Strategies in Low-Income, Middle-Income, and High-Income Countries: A Systematic Review

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