Evidence-based medicine and health economics: a case study of end stage renal disease

Vale, Luke; Donaldson, Cam; Daly, Conal; Campbell, Marion K; Cody, June D; Grant, Adrian; Khan, Izhar; Lawrence, Paul; Wallace, S; MacLeod, Alison Murray

doi:10.1002/1099-1050(200006)9:4<337::aid-hec518>3.0.co;2-o

Cited by 4 publications

(1 citation statement)

References 24 publications

(33 reference statements)

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“…While economic evaluations alongside randomised, double-blind controlled trials are the gold standard for CEA as they contain the least bias, modelling and ad hoc syntheses of data from several sources including expert opinion is accepted as a valid and necessary scientific procedure for estimating effectiveness. Also, while metaanalyses of effectiveness data, such as a Cochrane review, provide even stronger evidence of the effectiveness of interventions than most single RCTs could, the methods for identifying cost-effectiveness using Cochrane reviews has not been fully developed yet (Vale et al 2000). Models are advised not to be habitually used as they are not substitutes for direct primary or secondary empirical evaluation of effectiveness.…”

Section: Economic Valuementioning

confidence: 99%

Introduction

Guerriero¹

2020

Cost-Benefit Analysis of Environmental Health Interventions

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Box 1.1. Strategic policy directions adopted by the WHO's global cabinet Box 2.1. Summary of BMJ economic evaluation guidelines (from Drummond and Jefferson 1996) Cost-effectiveness of environmental health interventions v FOREWORD This document has been developed with the aim to provide an overview of currently used methods for economic evaluation and to discuss implications of using these methods for evaluating environmental health interventions. It aims at formulating recommendations for future evaluations in environmental health. The document is intended to contribute to the methodological discussions, and in particular the development of guidelines for evaluation of cost-effectiveness in the framework of WHO's initiatives, and other ongoing work in this area. This work constitutes a background document with preliminary considerations of methods for economic evaluations in environmental health. This document in particular focuses on what is peculiar to environmental health interventions, and therefore how the conduct of economic evaluations may need to be different to other health interventions. The main peculiarity, or difference, is that environmental health is a cross-cutting area. Environmental health interventions may need to be addressed, funded and implemented by various sectors (the health sector, the environment sector, the industrial sector, the transport sector, water or infrastructure services). In return, the benefits from environmental health interventions also accrue to various sectors and sometimes also to fulfil basic needs and increase the comfort or quality of life of the receiver (such as improved water supply). This issue raises the question: "Who will pay for (which part of) the intervention?". In relation to economic evaluation, therefore, it should be decided how the benefits should be accounted for in the cost-effectiveness (or cost-benefit) ratio. Furthermore, environmental health also deals with some exposures with very longterm effects, such as climate change, certain occupational exposures, changes in ecosystems with (short and) long-term effects on health, for example through the change in vector populations. Discounting health, even at very small rates, would make almost any impacts with very long latencies seem negligible, thus raising the question "how can discounting for long-term health effects be compatible with the concepts of prevention and sustainability?"

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Section: Economic Valuementioning

confidence: 99%

Introduction

Guerriero¹

2020

Cost-Benefit Analysis of Environmental Health Interventions

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The Role of Health Economics in Decision‐Making

Phillips¹

2005

Health Economics: An Introduction for Health Professionals

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Gold

Pastores

Botteman

et al. 2002

Quality of Life Research

100

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This paper is the first of its kind to study the impact of Fabry disease (FD) in affected males, and shows that FD is associated with a significant decline in several domains. Using the medical outcomes study (MOS) SF-36 and a FD-specific questionnaire, we compared the observations found among these patients with that obtained for the general US population and other chronic disease states, including Gaucher disease (GD) (another lysosomal storage disorder), end-stage renal disease, stoke and AIDS. Patients with FD have a score profile most similar to patients with AIDS. In comparison with patients with GD, Fabry patients score substantially lower across all domains. Using simple linear regression, potential predictors of health-related quality of life (HRQOL) for Fabry patients were also determined. As in the general population, stroke, cardiac problems and renal disease lead to substantial decrement in HRQOL. In addition, two disease specific symptoms (acroparesthesia and anhidrosis) and pain are also predictors of decreased quality of life. Currently, no specific therapy for FD exists. As enzyme therapy for FD becomes increasingly available, it will be interesting to evaluate the therapy's impact on the quality of life of patients.

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Evidence-based medicine and health economics: a case study of end stage renal disease

Cited by 4 publications

References 24 publications

Introduction

Introduction

The Role of Health Economics in Decision‐Making

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