Module 1 2021

Economic Evaluation

 In 1973: “More bangs for your bucks”  Today: “The analysis of two or more treatment options ordered, in ascending order, by effectiveness. Effectiveness should be measured using the universally recognised quality- adjusted life year (measured using appropriate tools such as the standard gamble or time trade-off), whilst costs should include only those costs which are directly related to the decision-making body (or a wider perspective, if required). Incremental analysis is carried out between treatment options, with those options which are ‘dominated’, by direct or extended dominance, being removed from the analysis. Incremental cost-effectiveness ratios are calculated for the remaining options, and compared against a pre-determined threshold. The most cost-effective treatment option is that which offers the greatest effectiveness, whilst remaining below the incremental cost-effectiveness threshold. Uncertainty should be accounted for in the decision problem by the use of univariate and multivariate sensitivity analysis, producing a range of cost-effectiveness acceptability curves (CEACs) for a range of potential threshold values. Scenario analyses may also be required in order to test the structural validity of the model(s). The threshold value, k, should reflect the relative value of the displaced activities, that is, those treatment that are foregone as a result of the expenditure on the new technology. If wider, societal, costs are included in the analysis, then a societal willingness-to-pay per QALY, may be required as well as the estimated value of the displaced treatment. The affordability of the new treatment…”

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Economic Evaluation: Principles

COSTS (£)

BENEFITS

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