Academic literature on the topic 'Incremental cost-effectiveness ratio'
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Journal articles on the topic "Incremental cost-effectiveness ratio"
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Bang, Heejung, and Hongwei Zhao. "Median-Based Incremental Cost-Effectiveness Ratio (ICER)." Journal of Statistical Theory and Practice 6, no. 3 (September 2012): 428–42. http://dx.doi.org/10.1080/15598608.2012.695571.
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Severens, Johan L., Theo M. De Boo, and Emmy M. Konst. "UNCERTAINTY OF INCREMENTAL COST-EFFECTIVENESS RATIOS." International Journal of Technology Assessment in Health Care 15, no. 3 (July 1999): 608–14. http://dx.doi.org/10.1017/s0266462399153157.
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Objective: To compare different methods to estimate the confidence interval of the incremental cost-effectiveness ratio (ICER).Methods: The adequacy of Fieller intervals and three methods for calculating bootstrap intervals are compared based on a simulation of 10,000 trials, using data from one trial.Results: Both Fieller and bootstrap methods lead to unsatisfactory results when the difference in effectiveness is approximately zero. Where this difference is significant, the four methods for calculating confidence intervals for ICER do not give very different results, but Fieller's interval performs best.Conclusions: Since Fieller's confidence limits are relatively easy to compute compared with bootstrap simulations, we recommend using this method.
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Lucherini, Stefano, Robert Hughes, and Paul Okhuoya. "PD44 Multi-Comparator Incremental Cost-Effectiveness Ratio: A New Framework For Cost-Effectiveness Analysis." International Journal of Technology Assessment in Health Care 34, S1 (2018): 144–45. http://dx.doi.org/10.1017/s0266462318003112.
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Introduction:Current practice in cost-effectiveness analysis (CEA) involves the estimation of the incremental cost-effectiveness ratio (ICER) between a new intervention and one alternative comparator reflecting the standard of care. As this focuses on pairwise comparisons, rather than considering the whole range of available alternatives at any given time, this method fails to capture the full impact of bringing the new intervention to market.Methods:A multi-comparator ICER (MC-ICER) evaluating the impact of the new technology on patients treated with all comparators used in clinical practice, rather than a theoretical ‘second-best’ alternative only, was estimated. This can be achieved by weighting the incremental costs and benefits for each comparator by its change in market share to generate an MC-ICER. This is shown using a stylized example with three comparators.Results:The traditional ICER against the second-best alternative was USD 200,000 per QALY, while the estimated multi-comparator ICER is USD 133,548 per QALY, corresponding to a 33 percent decrease. This reflects the fact that patients who switch to the new intervention are not only those who had been previously treated with one particular comparator, as is assumed in a traditional CEA. The difference between the traditional ICER and the MC-ICER depends on how the new intervention impacts on the uptake of each comparator.Conclusions:Results show that, when comparator selection was made excluding dominated and extendedly-dominated alternatives, the MC-ICER, produced using the method described above, is lower than the traditional ICER comparing the new intervention to the second-best comparator. This captures the fact that patients may switch to the new intervention not only from the second-best comparator, but from the whole range of alternative treatments. Such patient movements determine the real impact, or opportunity cost, of the new intervention on the healthcare system and, therefore, should be captured in CEA alongside traditional one-way ICERs.
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Heitjan, Daniel F., Alan J. Moskowitz, and William Whang. "Problems with Interval Estimates of the Incremental Cost—Effectiveness Ratio." Medical Decision Making 19, no. 1 (January 1999): 9–15. http://dx.doi.org/10.1177/0272989x9901900102.
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Frisman, M., and B. Geltzer. "PCV7: INCREMENTAL COST-EFFECTIVENESS RATIO IN ESTIMATION SOME HYPOTENSIVE DRUGS." Value in Health 3, no. 5 (September 2000): 312. http://dx.doi.org/10.1016/s1098-3015(11)70660-x.
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Cheung, Matthew C., Kelvin KW Chan, Shane Golden, Annette Hay, Joseph Pater, Anca Prica, Bingshu E. Chen, Natasha Leighl, and Nicole Mittmann. "Minimization of resource utilization data collected within cost-effectiveness analyses conducted alongside Canadian Cancer Trials Group phase III trials." Clinical Trials 18, no. 4 (April 19, 2021): 500–504. http://dx.doi.org/10.1177/17407745211005045.
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Background Cost-effectiveness analyses embedded within randomized trials allow for evaluation of value alongside conventional efficacy outcomes; however, collection of resource utilization data can require considerable trial resources. Methods We re-analyzed the results from four phase III Canadian Cancer Trials Group trials that embedded cost-effectiveness analyses to determine the impact of minimizing potential cost categories on the incremental cost-effectiveness ratios. For each trial, we disaggregated total costs into component incremental cost categories and recalculated incremental cost-effectiveness ratios using (1) only the top 3 cost categories, (2) the top 5 cost categories, and (3) all cost components. Using individual trial-level data, confidence intervals for each incremental cost-effectiveness ratio simulation were generated by bootstrapping and descriptively presented with the original confidence intervals (and incremental cost-effectiveness ratios) from the publications. Results Drug acquisition costs represented the highest incremental cost category in three trials, while hospitalization costs represented the other consistent cost driver and the top incremental cost category in the fourth trial. Recalculated incremental cost-effectiveness ratios based on fewer cost components (top 3 and top 5) did not differ meaningfully from the original published results. Based on conventional willingness-to-pay thresholds (US$50,000–US$100,000 per quality-adjusted life-year), none of the re-analyses would have changed the original perception of whether the experimental therapies were considered cost-effective. Conclusions These results suggest that the collection of resource utilization data within cancer trials could be narrowed. Omission of certain cost categories that have minimal impact on incremental cost-effectiveness ratio, such as routine laboratory investigations, could reduce the costs and undue burden associated with the collection of data required for cancer trial cost-effectiveness analyses.
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Goldstein, Daniel A., Bilal B. Ahmad, Qiushi Chen, Turgay Ayer, David H. Howard, Joseph Lipscomb, Bassel F. El-Rayes, and Christopher R. Flowers. "Cost-Effectiveness Analysis of Regorafenib for Metastatic Colorectal Cancer." Journal of Clinical Oncology 33, no. 32 (November 10, 2015): 3727–32. http://dx.doi.org/10.1200/jco.2015.61.9569.
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Purpose Regorafenib is a standard-care option for treatment-refractory metastatic colorectal cancer that increases median overall survival by 6 weeks compared with placebo. Given this small incremental clinical benefit, we evaluated the cost-effectiveness of regorafenib in the third-line setting for patients with metastatic colorectal cancer from the US payer perspective. Methods We developed a Markov model to compare the cost and effectiveness of regorafenib with those of placebo in the third-line treatment of metastatic colorectal cancer. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Drug costs were based on Medicare reimbursement rates in 2014. Model robustness was addressed in univariable and probabilistic sensitivity analyses. Results Regorafenib provided an additional 0.04 QALYs (0.13 life-years) at a cost of $40,000, resulting in an incremental cost-effectiveness ratio of $900,000 per QALY. The incremental cost-effectiveness ratio for regorafenib was > $550,000 per QALY in all of our univariable and probabilistic sensitivity analyses. Conclusion Regorafenib provides minimal incremental benefit at high incremental cost per QALY in the third-line management of metastatic colorectal cancer. The cost-effectiveness of regorafenib could be improved by the use of value-based pricing.
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Fukuda, Haruhisa, and Kensuke Moriwaki. "Cost-Effectiveness Analysis of Safety-Engineered Devices." Infection Control & Hospital Epidemiology 37, no. 9 (May 26, 2016): 1012–21. http://dx.doi.org/10.1017/ice.2016.110.
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OBJECTIVETo estimate the cost-effectiveness of safety-engineered devices (SEDs) relative to non-SEDs for winged steel needles, intravenous catheter stylets, suture needles, and insulin pen needles.DESIGNDecision analysis modeling.PARTICIPANTSHypothetical cohort of healthcare workers who utilized needle devices.METHODSWe developed a decision-analytic model to estimate and compare the life-cycle costs and benefits for SED and non-SED needle devices. For this cost-effectiveness analysis, we quantified the total direct medical cost per needlestick injury, number of needlestick injuries avoided, and incremental cost-effectiveness ratio. Sensitivity analyses were performed to examine the robustness of the base-case analysis.RESULTSIn the base-case analysis, we calculated the incremental cost-effectiveness ratios of SED winged steel needles, intravenous catheter stylets, suture needles, and insulin pen needles to be $2,633, $13,943, $1,792, and $1,269 per needlestick injury avoided, respectively. Sensitivity analyses showed that the calculated incremental cost-effectiveness ratio values for using SEDs did not fall below zero even after adjusting the values of each parameter.CONCLUSIONThe use of SED needle devices would not produce cost savings for hospitals. Government intervention may be needed to systematically protect healthcare workers in Japan from the risk of bloodborne pathogen infections.Infect Control Hosp Epidemiol 2016;37:1012–1021
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Wu, Chien-Hua, and Shu-Mei Wan. "The precision of regression-type estimator for incremental cost–effectiveness ratio." Journal of Statistical Computation and Simulation 82, no. 8 (August 2012): 1105–14. http://dx.doi.org/10.1080/00949655.2011.572073.
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Veronesi, Giulia, Niccolò Navone, Pierluigi Novellis, Elisa Dieci, Luca Toschi, Laura Velutti, Michela Solinas, Elena Vanni, Marco Alloisio, and Simone Ghislandi. "Favorable incremental cost-effectiveness ratio for lung cancer screening in Italy." Lung Cancer 143 (May 2020): 73–79. http://dx.doi.org/10.1016/j.lungcan.2020.03.015.
Full textDissertations / Theses on the topic "Incremental cost-effectiveness ratio"
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Lux, Michael P., Achim Wöckel, Agnes Benedict, Stefan Buchholz, Noémi Kreif, Nadia Harbeck, Rolf Kreienberg, et al. "Cost-Effectiveness Analysis of Anastrozole versus Tamoxifen in Adjuvant Therapy for Early-Stage Breast Cancer – a Health-Economic Analysis Based on the 100-Month Analysis of the ATAC Trial and the German Health System." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-134902.
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Background: In the ‘Arimidex’, Tamoxifen Alone or in Combination (ATAC) trial, the aromatase inhibitor (AI) anastrozole had a ignificantly better efficacy and safety profile than tamoxifen as initial adjuvant therapy for hormone receptor-positive (HR+) early breast cancer (EBC) in postmenopausal patients. To compare the combined long-term clinical and economic benefits, we carried out a cost-effectiveness analysis (CEA) of anastrozole versus tamoxifen based on the data of the 100- month analysis of the ATAC trial from the perspective of the German public health insurance. Patients and Methods: A Markov model with a 25-year time horizon was developed using the 100-month analysis of the ATAC trial as well as data obtained from published literature and expert opinion. Results: Adjuvant treatment of EBC with anastrozole achieved an additional 0.32 quality-adjusted life-years (QALYs) gained per patient compared with tamoxifen, at an additional cost of D 6819 per patient. Thus, the incremental cost effectiveness of anastrozole versus tamoxifen at 25 years was D 21,069 ($ 30,717) per QALY gained. Conclusions: This is the first CEA of an AI that is based on extended follow-up data, taking into account the carryover effect of anastrozole, which maintains the efficacy benefits beyond therapy completion after 5 years. Adjuvant treatment with anastrozole for postmenopausal women with HR+ EBC is a cost-effective alternative to tamoxifenHintergrund: Bei der adjuvanten Therapie von postmenopausalen Patientinnen mit Hormonrezeptor-positivem (HR+) Mammakarzinom belegen die ATAC-100-Monatsdaten (ATAC-Studie: ‘Arimidex’, Tamoxifen Alone or in Combination) einen signifikanten Vorteil von Anastrozol gegenüber Tamoxifen in Bezug auf Rezidivrisiko und Verträglichkeit. Es wurde eine Kosten-Nutzwert-Analyse von Anastrozol im Vergleich zu Tamoxifen aus der Sicht des deutschen Gesundheitssystems durchgeführt. Material und Methoden: Als Berechnungsbasis wurde ein Markov- Modell zur Abschätzung der Kosteneffektivität entwickelt. Der Modellierungszeitraum umfasste 25 Jahre. Die Daten wurden anhand der ATAC-100-Monatsdaten, vorliegender Literatur und durch ein interdisziplinäres Expertenteam ermittelt. Ergebnisse: Eine adjuvante Therapie mit Anastrozol erzielte 0,32 quality-adjusted life-years (QALYs) pro Patientin mehr, verglichen mit einer adjuvanten Tamoxifentherapie. Die zusätzlichen Kosten der Therapie mit Anastrozol lagen bei 6819 D pro Patientin. Im Vergleich mit Tamoxifen erzielte Anastrozol einen ICER (Incremental Cost-Effectiveness Ratio) von 21 069 D (30 717 $)/QALY über den gesamten Modellierungszeitraum. Schlussfolgerung: Diese Kosten- Nutzwert-Analyse eines Aromatasehemmers basiert erstmals auf einer Datenanalyse, die auch das Follow-Up und den sogenannten Carryover- Effekt nach einer abgeschlossenen 5-Jahres-Therapie beinhaltet. Anastrozol ist auch nach dieser Analyse aus der Sicht des deutschen Gesundheitssystems eine kosteneffektive Therapieoption für postmenopausale Patientinnen mit einem HR+ frühen Mammakarzinom
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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Moye, William Andrew. "Cost-effectiveness Analysis of Preimplantation Genetic Screening." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4806.
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In vitro fertilization (IVF) is used to help infertile couples achieve a live birth. Clinical studies have suggested that multiple, consecutive cycles of IVF can increase live birth rate significantly. Others have documented improved live birth rates from the use of new laboratory techniques for preimplantation genetic screening (PGS). This genetic screening technique seeks to determine the ploidy of the embryo prior to implantation into the woman. To date, no study has examined the cost-effectiveness of using IVF in conjunction with PGS compared to that of IVF alone for 3 consecutive cycles in achieving a live birth. This study compared the incremental cost-effectiveness ratios (ICER) from each intervention arm based on the clinical probabilities for each outcome and this study was grounded in the protection motivation theory. Costs were obtained from secondary sources, such as the literature and government databases. The model was constructed using a decision-analytical approach that allowed for z test statistical analysis of the outcomes, where the ICER is the dependent variable and the independent variables are the 2 interventions. The robustness of the model was tested through univariate and probabilistic sensitivity analysis and stratified by age groups. The results showed that PGS with IVF was cost-effective for women aged under 40 and women aged 40-42, but not for women over 42. Based on a willingness-to-pay threshold of $100,000, IVF with PGS was the most cost-effective strategy in all age groups. The positive social change implication of this study is such that understanding the costs associated with a new technology to achieve a live birth is significant for society to help guide clinical treatment of these patients.
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Lux, Michael P., Achim Wöckel, Agnes Benedict, Stefan Buchholz, Noémi Kreif, Nadia Harbeck, Rolf Kreienberg, et al. "Cost-Effectiveness Analysis of Anastrozole versus Tamoxifen in Adjuvant Therapy for Early-Stage Breast Cancer – a Health-Economic Analysis Based on the 100-Month Analysis of the ATAC Trial and the German Health System." Karger, 2010. https://tud.qucosa.de/id/qucosa%3A27603.
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Background: In the ‘Arimidex’, Tamoxifen Alone or in Combination (ATAC) trial, the aromatase inhibitor (AI) anastrozole had a ignificantly better efficacy and safety profile than tamoxifen as initial adjuvant therapy for hormone receptor-positive (HR+) early breast cancer (EBC) in postmenopausal patients. To compare the combined long-term clinical and economic benefits, we carried out a cost-effectiveness analysis (CEA) of anastrozole versus tamoxifen based on the data of the 100- month analysis of the ATAC trial from the perspective of the German public health insurance. Patients and Methods: A Markov model with a 25-year time horizon was developed using the 100-month analysis of the ATAC trial as well as data obtained from published literature and expert opinion. Results: Adjuvant treatment of EBC with anastrozole achieved an additional 0.32 quality-adjusted life-years (QALYs) gained per patient compared with tamoxifen, at an additional cost of D 6819 per patient. Thus, the incremental cost effectiveness of anastrozole versus tamoxifen at 25 years was D 21,069 ($ 30,717) per QALY gained. Conclusions: This is the first CEA of an AI that is based on extended follow-up data, taking into account the carryover effect of anastrozole, which maintains the efficacy benefits beyond therapy completion after 5 years. Adjuvant treatment with anastrozole for postmenopausal women with HR+ EBC is a cost-effective alternative to tamoxifen.Hintergrund: Bei der adjuvanten Therapie von postmenopausalen Patientinnen mit Hormonrezeptor-positivem (HR+) Mammakarzinom belegen die ATAC-100-Monatsdaten (ATAC-Studie: ‘Arimidex’, Tamoxifen Alone or in Combination) einen signifikanten Vorteil von Anastrozol gegenüber Tamoxifen in Bezug auf Rezidivrisiko und Verträglichkeit. Es wurde eine Kosten-Nutzwert-Analyse von Anastrozol im Vergleich zu Tamoxifen aus der Sicht des deutschen Gesundheitssystems durchgeführt. Material und Methoden: Als Berechnungsbasis wurde ein Markov- Modell zur Abschätzung der Kosteneffektivität entwickelt. Der Modellierungszeitraum umfasste 25 Jahre. Die Daten wurden anhand der ATAC-100-Monatsdaten, vorliegender Literatur und durch ein interdisziplinäres Expertenteam ermittelt. Ergebnisse: Eine adjuvante Therapie mit Anastrozol erzielte 0,32 quality-adjusted life-years (QALYs) pro Patientin mehr, verglichen mit einer adjuvanten Tamoxifentherapie. Die zusätzlichen Kosten der Therapie mit Anastrozol lagen bei 6819 D pro Patientin. Im Vergleich mit Tamoxifen erzielte Anastrozol einen ICER (Incremental Cost-Effectiveness Ratio) von 21 069 D (30 717 $)/QALY über den gesamten Modellierungszeitraum. Schlussfolgerung: Diese Kosten- Nutzwert-Analyse eines Aromatasehemmers basiert erstmals auf einer Datenanalyse, die auch das Follow-Up und den sogenannten Carryover- Effekt nach einer abgeschlossenen 5-Jahres-Therapie beinhaltet. Anastrozol ist auch nach dieser Analyse aus der Sicht des deutschen Gesundheitssystems eine kosteneffektive Therapieoption für postmenopausale Patientinnen mit einem HR+ frühen Mammakarzinom.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Hassan, Syed. "Three Essays in Health Economics." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37361.
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This thesis consists of three chapters. The first chapter explores the effects of prenatal nutritional deficiency on depression in adulthood. It is well established that maternal behaviour during pregnancy has a lasting effect on the child for years to come. Studies show that in utero nutritional shocks can have prolonged effects on health and labour market outcomes later in life of the offspring. In this paper I investigate whether such nutritional deficiencies during gestation can have an extended impact on mental health in adulthood. Using the fourth wave of Indonesian Family Life Survey (IFLS), I find that Muslim individuals who were potentially exposed to Ramadan in the first and third trimester have significantly higher scores on the depression scale than those who were not exposed. This effect is particularly significant among Muslim males who were exposed in the first trimester and Muslim females who were exposed in the third trimester. Similar effects of exposure are also found on the probability of being depressed in the Muslim population. The absence of such impact of exposure in the non-Muslim population suggests that nutritional deficiencies during the gestation period can have lasting effects on mental health and may increase the possibility of developing depression later in life. Next, the literature on socioeconomic health inequality uses individuals' socioeconomic rank (p) to develop the concentration index. In the second chapter of the thesis, I construct an alternative framework by directly using individuals' income level (y) to rank them and develop stochastic dominance conditions to investigate whether this method leads to the same conclusion as using the socioeconomic ranks (p). Using World Health Survey data for five South Asian countries, I conclude that using the socioeconomic ranks (p) and income levels (y) to rank individuals lead to different results in dominance tests adjusted for different equivalence scales. Lastly, to address the arbitrariness problem of the health concentration index's value caused by assuming the existence of a ratio-scaled variable, Makdissi and Yazbeck (2014) adopted a counting approach to measure health inequality. In the third chapter of the thesis, I apply this counting approach in a two-fold way. Firstly, I estimate the values of population health status and health inequality in United States using the National Health Interview Survey (2010) data. Then, assuming increased government expenditure on health awareness, I simulate the effects such policy interventions and see what improvements in the public health can be achieved. Also, I propose the count-approach incremental cost effectiveness ratio (C-ICER) which is a simple measure to assess the cost effectiveness of public health awareness campaigns.
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Clare, Virginia Mary. "A review of the economic consequences of a policy of universal leucodepletion as compared to existing practices." Thesis, Queensland University of Technology, 2009. https://eprints.qut.edu.au/30329/1/Virginia_Clare_Thesis.pdf.
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Leucodepletion, the removal of leucocytes from blood products improves the safety of blood transfusion by reducing adverse events associated with the incidental non-therapeutic transfusion of leucocytes. Leucodepletion has been shown to have clinical benefit for immuno-suppressed patients who require transfusion. The selective leucodepletion of blood products by bed side filtration for these patients has been widely practiced. This study investigated the economic consequences in Queensland of moving from a policy of selective leucodepletion to one of universal leucodepletion, that is providing all transfused patients with blood products leucodepleted during the manufacturing process. Using an analytic decision model a cost-effectiveness analysis was conducted. An ICER of $16.3M per life year gained was derived. Sensitivity analysis found this result to be robust to uncertainty in the parameters used in the model. This result argues against moving to a policy of universal leucodepletion. However during the course of the study the policy decision for universal leucodepletion was made and implemented in Queensland in October 2008. This study has concluded that cost-effectiveness is not an influential factor in policy decisions regarding quality and safety initiatives in the Australian blood sector.
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Clare, Virginia Mary. "A review of the economic consequences of a policy of universal leucodepletion as compared to existing practices." Queensland University of Technology, 2009. http://eprints.qut.edu.au/30329/.
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Leucodepletion, the removal of leucocytes from blood products improves the safety of blood transfusion by reducing adverse events associated with the incidental non-therapeutic transfusion of leucocytes. Leucodepletion has been shown to have clinical benefit for immuno-suppressed patients who require transfusion. The selective leucodepletion of blood products by bed side filtration for these patients has been widely practiced. This study investigated the economic consequences in Queensland of moving from a policy of selective leucodepletion to one of universal leucodepletion, that is providing all transfused patients with blood products leucodepleted during the manufacturing process. Using an analytic decision model a cost-effectiveness analysis was conducted. An ICER of $16.3M per life year gained was derived. Sensitivity analysis found this result to be robust to uncertainty in the parameters used in the model. This result argues against moving to a policy of universal leucodepletion. However during the course of the study the policy decision for universal leucodepletion was made and implemented in Queensland in October 2008. This study has concluded that cost-effectiveness is not an influential factor in policy decisions regarding quality and safety initiatives in the Australian blood sector.
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Sientchkovski, Paula Marques. "Construção de ferramenta computacional para estimação de custos na presença de censura utilizando o método da Ponderação pela Probabilidade Inversa." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2016. http://hdl.handle.net/10183/148105.
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Introdução: Dados de custo necessários na Análise de Custo-Efetividade (CEA) são, muitas vezes, obtidos de estudos longitudinais primários. Neste contexto, é comum a presença de censura caracterizada por não se ter os dados de custo a partir de certo momento, devido ao fato de que indivíduos saem do estudo sem esse estar finalizado. A ideia da Ponderação pela Probabilidade Inversa (IPW – do inglês, Inverse Probability Weighting) vem sendo bastante estudada na literatura relacionada a esse problema, mas é desconhecida a disponibilidade de ferramentas computacionais para esse contexto. Objetivo: Construir ferramentas computacionais em software Excel e R, para estimação de custos pelo método IPW conforme proposto por Bang e Tsiatis (2000), com o objetivo de lidar com o problema da censura em dados de custos. Métodos: Através da criação de planilhas eletrônicas em software Excel e programação em software R, e utilizando-se bancos de dados hipotéticos com situações diversas, busca-se propiciar ao pesquisador maior entendimento do uso desse estimador bem como a interpretação dos seus resultados. Resultados: As ferramentas desenvolvidas, ao proporcionarem a aplicação do método IPW de modo intuitivo, se mostraram como facilitadoras para a estimação de custos na presença de censura, possibilitando calcular a ICER a partir de dados de custo. Conclusão: As ferramentas desenvolvidas permitem ao pesquisador, além de uma compreensão prática do método, a sua aplicabilidade em maior escala, podendo ser considerada como alternativa satisfatória às dificuldades postas pelo problema da censura na CEA.Introduction: Cost data needed in Cost-Effectiveness Analysis (CEA) are often obtained from longitudinal primary studies. In this context, it is common the presence of censoring characterized by not having cost data after a certain point, due to the fact that individuals leave the study without this being finalized. The idea of Inverse Probability Weighting (IPW) has been extensively studied in the literature related to this problem, but is unknown the availability of computational tools for this context. Objective: To develop computational tools in software Excel and software R, to estimate costs by IPW method, as proposed by Bang and Tsiatis (2000), in order to deal with the problem of censorship in cost data. Methods: By creating spreadsheets in Excel software and programming in R software, and using hypothetical database with different situations, we seek to provide to the researcher most understanding of the use of IPW estimator and the interpretation of its results. Results: The developed tools, affording the application of IPW method in an intuitive way, showed themselves as facilitators for the cost estimation in the presence of censorship, allowing to calculate the ICER from more accurate cost data. Conclusion: The developed tools allow the researcher, besides a practical understanding of the method, its applicability on a larger scale, and may be considered a satisfactory alternative to the difficulties posed by the problem of censorship in CEA.
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Sondhi, Manu. "Effect of time horizon on incremental cost-effectiveness ratios." Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/33846.
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Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2005.Includes bibliographical references (leaves 74-76).
Background: Estimation of cost-effectiveness of a therapy as compared with another, in healthcare, is often based on a single perspective and a single time horizon. In this thesis, I explored methods of extrapolating the survival effect of different interventions and the effect of time horizon on incremental cost-effectiveness ratios when comparing two strategies. Methods: Two strategies for a patient are compared: new or usual treatment. A hypothetical model based on US life tables (for a 64-year old) assumed that the new and usual treatment strategies resulted in patient survivals identical to a person who is 5 and 10 years older, respectively, than the patient's chronologic age. The hazard rates over time were calculated and transformed to linear equations for least-squares linear regression to fit exponential, linear exponential, Weibull and Gompertz distributions. The survival model yielding the maximal likelihood estimate was extrapolated over different time horizons: 5, 10 and 15-year in addition to lifetime. In addition, I extracted survival data from a published trial evaluating thrombolysis in patients with myocardial infarction and applied this methodology over different time horizons.
(cont.) Finally, I developed a matrix of incremental cost-effectiveness ratios over different time horizons, based on an overview model, examining alternative assumptions when the cumulative difference in cost and effectiveness of the two strategies: 1) decrease 2) remain constant or 3) increase. I used a statistical programming language "R" for evaluation and analysis. Results: When considering a US life-table based hypothetical model, Gompertz curve was the best-fitting model. A linear-exponential model had the best fit when considering a survival model of thrombolysis patients. A matrix of incremental cost-effectiveness ratios with decreasing, constant and increasing cumulative difference in cost and effectiveness showed considerable change in incremental cost-effectiveness ratios over different time horizons. The magnitude of effect of time horizon was flattened with increasing discount rate for future cumulative differences in cost and effectiveness. With the exception of similarly behaving and proportionate cumulative difference in cost and effectiveness leading to unchanged incremental cost-effectiveness ratios, incremental cost-effectiveness ratios decreased when cumulative difference in effectiveness increased and increased when cumulative difference in effectiveness decreased, irrespective of behavior of cumulative difference in costs.
(cont.) Conclusions: When conducting cost-effectiveness analysis of two competing strategies, choice of time horizon has a substantial effect. Incremental cost-effectiveness ratio changes considerably with changes in duration of time horizon. Discounting flattens the effect of time horizon in cost-effectiveness analysis. Care must be taken in choosing the time horizon in a cost-effectiveness analysis and alternative time horizons must be evaluated in all cost-effectiveness analyses.
by Manu Sondhi.
S.M.
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Chen, Wan-Ling, and 陳宛玲. "Bias and MSE of Incremental Cost-effectiveness Ratio." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/85857201528567337757.
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碩士中原大學
應用數學研究所
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Recently, the finance of National Health Insurance Bureau is closely related to public has been alarmed, so everyone concerned is that stakeholders are researching that how to reduce the payment in National Health Insurance and keeping the quantity, even that trying to promote the level of medical treatment, it is a question for people. However, raising the premium or changing the price of drug which attracts to everyone even criticizes it. Therefore, to reduce avoidable medical costs, the appropriate allocation of limited medical resources, National Health Insurance Bureau will be able to reduce the financial difficulties. In this article, we discuss treatment effect of drug using NNT and ICER. According to the literature, the unbiased estimate of the reciprocal of the probability is not available, but can find a much unbiased as the estimative value is estimated, we can obtain the data of NNT and ICER to compare by TPSE and generally estimates. By R statistical software random variables, to calculate the NNT and the ICER and other related data. The results show that when the sample size increases, the Bias of NNT estimated by TPSE is closer to 0 than generally estimates, and the MSE of NNT estimated by TPSE will be much stable and smaller than by generally estimates. Compare the results of ICER estimated by TPSE and generally estimates, different correlation coefficients and sample size will change the average error and MSE. When the sample size increases, Bias and MSE of TPSE is smaller than of CE. According to the results, estimated MSE of NNT and ICER by TPSE is smaller than CE and MSE composes Variance and square of Bias. So it can be say that it is near UMVUE. Finally, adding two examples of medical data, in the same confidence level, the confidence interval of NNT and ICER by TPSE are narrower than generally estimates. The results shows that estimate the NNT and ICER by TPSE is more precisely and possess superior performance in terms of bias and MSE.
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Chang, Yi-Hsuan, and 張沂瑄. "Sample size algorithm for incremental cost-effectiveness ratio analysis." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/d6g4f5.
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碩士中原大學
應用數學研究所
102
The biggest challenge of National Health Insurance (NHI) in Taiwan is to maintain the financial balance and provide good quality of medical service because it has to pay necessary remuneration to medical institutions, but only collect limited inexpensive insurance premium. The financial status of NHI becomes a concern because its medical budget is increasing year by year due to some inevitable factors, such as the aging population, expensive medical research and development and global economic recession. Simply speaking, the premium income is also far less than medical costs. However, raising premium benchmark or drug payment adjustment will result in some criticism from the public. Therefore, it is crucial to avoid unnecessary medical waste and reallocate the limited medical resources appropriately. This dissertation studies the calculation of sample size in the drug treatment that can be utilized in the real world to avoid excessive waste of resources and reduce the medical cost in terms of Cost-Effectiveness Analysis, Incremental Cost-effectiveness Ratio Analysis (ICER) and Incremental Net Benefit (INB). Keywords: Cost-Effectiveness Analysis, Incremental Cost-effectiveness Ratio Analysis, Incremental Net Benefit, significant level, power, confidence interval, sample size.
Books on the topic "Incremental cost-effectiveness ratio"
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Olsen, Jan Abel. Economic evaluation and priority setting: an overview. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198794837.003.0017.
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This chapter provides an overview of the methodologies that come under the umbrella term of economic evaluation in healthcare. Economic evaluations seek to identify, measure, value, and compare alternative programmes. A taxonomy is developed to distinguish economic evaluation techniques depending on whether benefits have been measured in money terms or not, and whether benefits are based on preferences or not. When benefits are measured in money terms, it is referred to as a cost–benefit analysis (CBA). If benefits are measured in health terms, some sort of cost-effectiveness analysis (CEA) is being used. An important class of CEA is what has come to be labelled ‘cost-utility-analysis’ (CUA). The chapter explains the incremental cost-effectiveness ratio (ICER) and illustrates the cost-effectiveness plane. Finally, the idea of discounting health is discussed.
Book chapters on the topic "Incremental cost-effectiveness ratio"
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Boltz, Marie, Holly Rau, Paula Williams, Holly Rau, Paula Williams, Jane Upton, Jos A. Bosch, et al. "Incremental Cost-Effectiveness Ratio (ICER)." In Encyclopedia of Behavioral Medicine, 1053. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4419-1005-9_1422.
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"Incremental Cost-Effectiveness Ratio." In Handbook of Disease Burdens and Quality of Life Measures, 4235. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-78665-0_5893.
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Hausman, Daniel M. "Cost-Effectiveness, Well-Being, and Freedom." In How Health Care Can Be Cost-Effective and Fair, 24—C2P39. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/oso/9780197656969.003.0003.
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Abstract One aim of health policy analysis is to identify the most “cost-effective” treatments—that is, the treatments with the smallest cost to effectiveness ratio. This chapter explains what allocation via cost-effectiveness involves in theory and, to some extent, in practice. It explains why something like cost-effectiveness is needed to allocate health care in a way that efficiently promotes health, and it also explains how comparing the incremental cost-effectiveness of a health care intervention to a threshold value implements allocation via cost-effectiveness. It offers a preliminary assessment of allocating health care by incremental cost-effectiveness by considering how successfully using this method to guide the allocation of health care resources promotes the fundamental values of making people better off and expanding their opportunities. Questions about the justice and fairness of c-e allocation will wait until Chapter 3.
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Simoens, Steven. "Cost-Effectiveness Analysis and the Value for Money of Health Technologies." In Pharmacoinformatics and Drug Discovery Technologies, 92–109. IGI Global, 2012. http://dx.doi.org/10.4018/978-1-4666-0309-7.ch007.
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Cost-effectiveness analysis serves as a tool to assess the value for money of a health technology. This chapter aims to review different approaches to assessing value for money of health technologies. First, the chapter discusses the methodological basis of the incremental cost-effectiveness ratio approach. Second, the chapter reviews alternative approaches such as the replacement approach, program budgeting and marginal analysis, the generalised optimisation framework, and multi-criteria decision analysis. This information will aid health care decision makers and researchers to interpret cost-effectiveness analyses and their results for the purpose of decision making.
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Hartfiel, Ned, and Rhiannon T. Edwards. "Cost–consequence analysis of public health interventions." In Applied Health Economics for Public Health Practice and Research, 233–47. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198737483.003.0010.
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This chapter opens with a discussion around cost–consequence analysis (CCA) and the UK’s NICE recommendation to use CCA in addition to cost–utility analysis for evaluating public health interventions. CCA is sometimes referred to as a disaggregated approach, because the benefits and costs are not combined in a single ratio such as incremental cost-effectiveness ratios (ICERs) in cost–utility analysis. CCA provides a clear descriptive summary for decision-makers that is often easier to interpret than cost-effectiveness, cost–utility, and cost–benefit analysis. The reader or the decision-maker has to form their own opinion concerning the relative importance of costs and outcomes. The chapter offers a case study of CCA by comparing a yoga-based intervention with self-care for managing musculoskeletal conditions in the workplace. The chapter ends with a summary of the principle benefits and major drawbacks of CCA.
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Skolasky, Richard, and Lee Riley. "Cost Utility Analysis: Use of Average Cost Per Quality-Adjusted Life Year Versus the Incremental Cost- Effectiveness Ratio." In Defining the Value of Spine Care, 129. Jaypee Brothers Medical Publishers (P) Ltd., 2012. http://dx.doi.org/10.5005/jp/books/11549_13.
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Yeo, Seow Tien, Huw Lloyd-Williams, and Rhiannon T. Edwards. "The supply and demand of preventive goods and services and the need for economic analysis." In Applied Health Economics for Public Health Practice and Research, 27–52. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198737483.003.0002.
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Chapter 2 introduces readers to micro-economic theory of utility, rational choice, and demand and supply. This chapter explains to readers why markets for healthcare goods and services fail and why this failure is so spectacular in the case of preventive goods and services. The chapter introduces readers to the need for economic evaluation in public health to guide the allocation of scarce public resources towards cost-effective prevention initiatives. This chapter goes on to explain the purpose of economic evaluation and its relationship to key concepts such as scarcity, choice, allocative efficiency, technical efficiency, and opportunity cost in health economics. With relevance to public health, readers are introduced to incremental cost-effectiveness ratios (ICERs), cost-effectiveness planes, and cost-effectiveness acceptability curves (CEACs), net monetary benefit (NMB), and their relationship to payer thresholds.
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Peter J., Neumann, Cohen Joshua T., and Ollendorf Daniel A. "Do Drugs for Special Populations Warrant Higher Prices?" In The Right Price, 151–72. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780197512883.003.0008.
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Despite its widespread acceptance, cost-effectiveness analysis, which examines an intervention’s incremental cost per unit of health gained, can run up against intuition in the context of drug coverage for conditions affecting special populations. In particular, the “rule of rescue” (i.e., spending more for populations perceived to be in immediate and great peril) may be justified for certain conditions. Examples include rare diseases and the “orphan drugs” used to treat them; cancer, with its attendant societal dread; and pediatric conditions, which are often inherited and severe. Cell and gene therapies may also challenge traditional value assessment, given their high manufacturing costs and potential for one-time, curative treatment. Health technology assessment (HTA) bodies worldwide have made exceptions for these populations by comparing cost-effectiveness ratios to higher (less stringent) benchmarks and by incorporating additional value considerations. Still, evaluating these higher-priced therapies remains a challenge for HTA and society.
Conference papers on the topic "Incremental cost-effectiveness ratio"
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Tamayo Bermejo, R., JC Del Río Valencia, B. Mora Rodríguez, and I. Muñoz Castillo. "4CPS-029 Pembrolizumab, nivolumab and atezolizumab: incremental cost-effectiveness ratio." In 26th EAHP Congress, Hospital pharmacists – changing roles in a changing world, 23–25 March 2022. British Medical Journal Publishing Group, 2022. http://dx.doi.org/10.1136/ejhpharm-2022-eahp.383.
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Bezbradica, Milan, and Zeljen Trpovski. "Advanced street lighting maintenance using GPS, light intensity measuring and incremental cost-effectiveness ratio." In 2014 International Conference on High Performance Computing & Simulation (HPCS). IEEE, 2014. http://dx.doi.org/10.1109/hpcsim.2014.6903752.
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Siani, Carole, and Christian de Peretti. "Algorithm for Making Decision with the Incremental Cost-Effectiveness Ratio handling the Mirror Decision-Making Problem." In Multiconference on "Computational Engineering in Systems Applications. IEEE, 2006. http://dx.doi.org/10.1109/cesa.2006.4281680.
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AlMukdad, Sawsan Ibrahim, Hazem Elewa, and Daoud Al-Badriyeh. "Economic Evaluation of CYP2C19 Genotype-Guided Antiplatelet Therapy Compared to Universal use of Ticagrelor or Clopidogrel in Qatar." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0170.
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Background: Patients having CYP2C19 loss-of-function alleles and receiving clopidogrel are at higher risk of adverse cardiovascular outcomes. Ticagrelor is a more effective and expensive antiplatelet that is unaffected by the CYP2C19 polymorphism. The main aim of the current research is to evaluate the cost-effectiveness among CYP2C19 genotype-guided therapy, universal ticagrelor, and universal clopidogrel after a percutaneous coronary intervention (PCI). Methods: A two-part simulation model, including a one-year decision-analytic model and a 20-year followup Markov model, was created to follow the use of (i) universal clopidogrel, (ii) universal ticagrelor, and (iii) genotype-guided antiplatelet therapy. Outcome measures were the incremental cost-effectiveness ratio (ICER, cost/success) and incremental cost-utility ratio (ICUR, cost/qualityadjusted life years [QALY]). Therapy success was defined as survival without myocardial infarction, stroke, cardiovascular death, stent thrombosis, and no therapy discontinuation because of adverse events, i.e. major bleeding and dyspnea. The model was based on a multivariate analysis, and a sensitivity analysis confirmed the robustness of the model outcomes. Results: Against universal clopidogrel, genotype-guided therapy was cost-effective over the one-year duration (ICER, USD 6,102 /success), and dominant over the long-term. Genotype-guided therapy was dominant over universal ticagrelor over the one-year duration and cost-effective over the long term (ICUR, USD 1,383 /QALY). Universal clopidogrel was dominant over ticagrelor over the short term, and cost-effective over the long-term (ICUR, 10,616 /QALY). Conclusion: CYP2C19 genotype-guided therapy appears to be the preferred antiplatelet strategy, followed by universal clopidogrel, and then universal ticagrelor for post-PCI patients in Qatar.
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Jayalath, C., and K. K. G. P. Somarathna. "KEY PERFORMANCE INDICATORS IN UPHOLDING SCOPE CREEP MANAGEMENT IN ROAD PROJECTS." In The 9th World Construction Symposium 2021. The Ceylon Institute of Builders - Sri Lanka, 2021. http://dx.doi.org/10.31705/wcs.2021.33.
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Scope creep has been a day-to-day occurrence in almost every major road project causing a considerable cost overrun with no early dimple. This paper offers a critical appraisal on the dominant causes behind scope creep in the road projects. A comprehensive literature survey was undertaken to explore the factors specifically contributing scope creep and various control measures that are adopted, among other purposes, in at least reducing the impact due to scope creep in the final delivery of road projects. The study included interviews with 15 experts to identify major issues and add their hands-on experience. A questionnaire survey was subsequently administered among 100 industrial personnel having a cost management background in order to evaluate the effectiveness of the key performance indicators (KPIs) in terms of taming scope creep. Results from the study showed that concomitant client instructions on additional features, unclear scope and incremental changes cause scope creep throughout the project. Among 53 KPIs identified, the most effective KPI that enables adequate control of scope creep in road projects is the cost efficiency ratio. The results enable comprehending the causes of scope creep and its resultant net effect on cost control.
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Hsieh, Yi-jhan. "Economic Analysis and Policy Suggestions for Prenatal Screening and Diagnosis on Down's Syndrome in China." In 2022 International Conference on Economic Administration and Information Systems. Clausius Scientific Press, 2022. http://dx.doi.org/10.23977/eais2022.020.
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Down Syndrome is a disease that can cause a significant economic burden on both society and individual families. It has a relatively high incidence compared to other conditions, but it can be detected with the proper use of prenatal screening and diagnostic tests. This paper conducted a cost-benefit analysis, cost-effectiveness analysis with the Incremental Cost-Effectiveness Ratio (ICER), a Criteria Importance through Intercriteria Correlation (CRITIC) model. Through using a Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) model to evaluate and compare the three different prenatal diagnostic tests for DS, amniocentesis, noninvasive prenatal testing (NIPT), and chorionic villus sampling (CVS). The result showed that amniocentesis and CVS are both cost-benefit and cost-effective, ranking the first in the CRITIC and TOPSIS models, with amniocentesis having a more significant lead. In contrast, NIPT has a negative net benefit and is not cost-effective, ranking third in both models. Amniocentesis should be compulsory in China, with the government covering $402 and individual families paying $98. Choices should be given to individual families if they are willing to pay more to take NIPT if they are worried about the risk of invasive amniocentesis. People with autoimmune diseases and other diseases that can increase the risk of miscarriage with an invasive test should be provided with NIPT with the government covering the extra fee. A selection system with the prenatal test for DS as the default choice is another option for policy implementation based on the nudge theory. This policy can release around $8,265,075,000 economic burden on the society and $1,100,000,000 on individual families annually in China, creating more economic value for the rapidly growing country.
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Grimm, Tyler J., Shubhamkar Kulkarni, Laine Mears, and Gregory Mocko. "Experimental Investigation of a Backing Sheet Stiffener in Incremental Forming of Polycarbonate." In ASME 2019 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/imece2019-11231.
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Abstract Single point incremental forming (SPIF) is a dieless forming process for sheet materials. This process forms materials with a hemispherical forming tool which locally deforms the sheet at incremental depths. The freeform nature of this process promises significant efficiency improvements within small and medium volume industries where stamping is traditionally used. However, several drawbacks currently inhibit its widespread use. One of these drawbacks is springback or elastic recovery resulting in reduced geometrical accuracy. An existing approach to counter this involves using a dedicated backing die, increasing the cost of the forming apparatus and the overall energy input per part. Other springback reduction methods involve the direct addition of energy to the workpiece through electrical or heat input. This study investigates the use of sacrificial steel blanks as backing dies for incremental forming of polycarbonate sheets, to overcome the loss in geometrical accuracy affiliated with forming geometries with a relatively large distance between the geometry periphery and the clamped edge. The blanks were not bound to each other, but rather clamped along their edges. In this study, polycarbonate blanks were tested using a three-factorial design of experiments, with relative plate thicknesses of 0.4, 0.5, and 0.6, and wall angles of 15°, 30°, 45°, and 60° as independent factors. The test geometry used was a straight walled pyramid with a square base. Using the backing sheet, a reduction in the springback was observed, demonstrating the effectiveness of sacrificial backing blanks. Particularly, the ‘pillow effect’ at the base of the geometry was reduced. This is attributed to the higher stiffness of the steel plates, increasing the plastic strain on the polycarbonate. However, the formability is found to decrease for higher values of the backing plate thickness due to premature steel failure. In future studies, this work will be expanded to include additional thickness ratios, geometries, toolpath types, step sizes and materials to form a more complete trend.