Discounting Health Outcomes in Economic Evaluation: The Ongoing Debate

Severens, Johan L.; Milne, Richard

doi:10.1111/j.1524-4733.2004.74002.x

Cited by 152 publications

(88 citation statements)

References 27 publications

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“…Adding trastuzumab to standard chemotherapy in the adjuvant setting introduces new side effects. Congestive heart failure is the most important factor in this setting and trastuzumab seems to be most cardiotoxic when given concomitant with doxorubicin [10,12,22,23]. However, when the drug is administered sequentially to chemotherapy, the risk seems to be in the 0.5 Á 2.2% range (HERA/N9831).…”

Section: Costsmentioning

confidence: 99%

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Trastuzumab in adjuvant breast cancer therapy. A model based cost-effectiveness analysis

et al. 2007

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Section: Costsmentioning

confidence: 99%

“…Most authors employ discount rates between 3% and 5% to incorporate future health outcomes and costs [23]. While 5% has been standard practice, most contemporary studies have applied 3%.We used a 3% discount rate and included 0% and 5% in the sensitivity analysis.…”

Section: Costsmentioning

confidence: 99%

Trastuzumab in adjuvant breast cancer therapy. A model based cost-effectiveness analysis

et al. 2007

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“…The annual discount rate for health outcomes was set to 5% as this value is among the generally accepted discount rates [24]. For an analysis conducted on a longer time horizon, the local discount rates will be used in the model.…”

Section: Model Settingsmentioning

confidence: 99%

Quality-adjusted life year difference in patients with predominant negative symptoms of schizophrenia treated with cariprazine and risperidone

Németh¹,

Molnár²,

Akehurst

et al. 2017

J. Comp. Eff. Res.

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Aim:Our study aimed at estimating differences in quality-adjusted life year (QALY) gain for patients with predominant negative symptoms of schizophrenia treated with cariprazine compared with risperidone. Materials & methods:A Markov model was built, based on the Mohr-Lenert approach and data derived from clinical trials, to estimate potential QALY gains of patients. Results: Patients had higher probability of reaching better health states treated with cariprazine compared with risperidone. In the model, this resulted in an estimated QALY gain of 0.029 per patient, after 1 year of treatment. Conclusion: Cariprazine, which showed clinically meaningful improvement in the symptoms, and personal and social performance, can also provide significant QALY gain in the treatment of patients with predominant negative symptoms of schizophrenia compared with risperidone.

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“…This methodology assumes static health after oneyear and no need for further intervention, which is considered the undiscounted health gain [8]. The QALYs gain was discounted at a rate of 5 % for each year of life expectancy to reflect a diminishing gain with time [9], as has been previously employed in arthroplasty health economic analysis [2]. The cost per QALY was then calculated (QALY gained/cost of prosthesis) at one year and for the expected lifetime of the cohort (adjusted and unadjusted).…”

Section: Study Population and Trial Designmentioning

confidence: 99%

Do modern total knee replacements offer better value for money? A health economic analysis

Hamilton

Clement

Burnett

et al. 2013

International Orthopaedics (SICOT)

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Purpose Cost effectiveness is an increasingly important factor in today's healthcare environment, and selection of arthroplasty implant is not exempt from such concerns. Quality adjusted life years (QALYs) are the typical tool for this type of evaluation. Using this methodology, joint arthroplasty has been shown to be cost effective; however, studies directly comparing differing prostheses are lacking. Methods Data was gathered in a single-centre prospective double-blind randomised controlled trial comparing the outcome of modern and traditional knee implants, using the Short Form 6 dimensional (SF-6D) score and quality adjusted life year (QALY) methodology. Results There was significant improvement in the SF-6D score for both groups at one year (p<0.0001). The calculated overall life expectancy for the study cohort was 15.1 years, resulting in an overall QALY gain of 2.144 (95 % CI 1.752-2.507). The modern implant group demonstrated a small improvement in SF-6D score compared to the traditional design at one year (0.141 versus 0.143, p=0.94). This difference resulted in the modern implant costing £298 less per QALY at one year. Conclusion This study demonstrates that modern implant technology does not influence the cost-effectiveness of TKA using the SF-6D and QALY methodology. This type of analysis however assesses health status, and is not sensitive to joint specific function. Evolutionary design changes in implant technology are thus unlikely to influence QALY analysis following joint replacement, which has important implications for implant procurement.

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Discounting Health Outcomes in Economic Evaluation: The Ongoing Debate

Cited by 152 publications

References 27 publications

Trastuzumab in adjuvant breast cancer therapy. A model based cost-effectiveness analysis

Trastuzumab in adjuvant breast cancer therapy. A model based cost-effectiveness analysis

Quality-adjusted life year difference in patients with predominant negative symptoms of schizophrenia treated with cariprazine and risperidone

Do modern total knee replacements offer better value for money? A health economic analysis

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