Quality-adjusted Years Research Articles

Затрато-эффективность лапароскопической парциальной резекции опухоли почки в Казахстане

Objective: to assess cost-effectiveness of laparoscopic partial nephrectomy in comparison with open partial resection of the kidney in Kazakhstan.Methods: A decision tree model was developed to simulate the clinical management of patients with an indication for partial kidney resection. In the model, patients used one of two technologies (laparoscopic and open). The time horizon was 1 year.Results. According to the, there is a difference in the costs of laparoscopic partial nephrectomy (862.558 tenge) with open partial nephrectomy (388.038 tenge) by 2.2 times due to the initial high cost of the former, while, in terms of number of quality-adjusted years laparoscopic partial nephrectomy (0.734 QALY) has advantages over open partial nephrectomy (0.711 QALY). The ICUR of laparoscopic partial nephrectomy compared to open partial nephrectomy crossed the assumed willingness to pay threshold (three times the gross domestic product for 2019-2020 -11.000,000 tenge) and amounted to 20.474.809 tenge/QALY.Conclusion. It is recommended to discuss the issue of revising the tariff for open partial nephrectomy (by 25% or higher), taking into account the increase in prices for drugs / medical devices and the costs associated with the stay of patients in the hospital.Keywords: laparascopic partial nephrectomy, cost-effectiveness analysis, open partial nephrectomy.

Cost-effectiveness analysis of five drugs for treating postmenopausal women in the United States with osteoporosis and a very high fracture risk.

Five strategies were recommended by the American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) guidelines for the treatment of postmenopausal osteoporosis (PMO) patients with a very high fracture risk. We aimed to assess their cost-effectiveness in the United States (US). A microsimulation Markov model was created to compare the cost-effectiveness of five treatment strategies, including zoledronate, denosumab, abaloparatide, teriparatide, and romosozumab in PMO patients with a recent fracture from the healthcare perspective of the US. The data used in the model were obtained from published studies or online resources. Base-case analysis, one-way deterministic sensitivity analysis (DSA) and probability sensitivity analysis (PSA) were conducted for 65-, 70-, 75-, and 80-year-old patients. In base case, at 65years, zoledronate was the cheapest strategy. The incremental cost-effectiveness ratios (ICER, which represent incremental costs per QALY gained) of denosumab, teriparatide, abaloparatide, and romosozumab against zoledronate were $13,020/QALY (quality-adjusted years), $477,331 /QALY, $176,287/QALY, and $98,953/QALY, respectively. Under a willing-to-pay (WTP, which means the highest price a consumer will pay for one unit of a good of service) threshold of $150,000/QALY, denosumab and romosozumab were cost-effective against zoledronate. The PSA results showed that denosumab was the most cost-effective option with WTP thresholds of $50,000/QALY, $100,000/QALY and $150,000/QALY. The results were similar in other age groups. The DSA results indicated that the most common parameters that have important influence on the outcome were drug persistence, incidence of adverse events, the efficacy of drugs on hip fractures and the cost of the drug. Among PMO patients with a very high fracture risk in the US, zoledronate is the cheapest strategy and denosumab is the most cost-effective choice among these five strategies.

Measuring human capital in middle income countries

This paper develops an indicator that measures the level of human capital to address the specific education and health challenges faced by middle income countries. We apply this indicator to countries in Europe and Central Asia, where productive employment requires skills that are more prevalent among higher education graduates, and where good health is associated to low levels of adult health risk factors. The Europe and Central Asia Human Capital Index (ECA-HCI) extends the World Bank's Human Capital Index by adding a measure of quality-adjusted years of higher education to the original education component, and it includes the prevalence of three adult health risk factors—obesity, smoking, and heavy drinking—as an additional proxy for latent health status. The results show that children born today in the average country in Europe and Central Asia will be almost half as productive as they would have had they reached the benchmark of complete education and full health. Countries with good basic education outcomes do not necessarily have good higher education outcomes, and high prevalence of adult health risk factors can offset good education indicators. This extension of the Human Capital Index could also be useful for assessing the state of human capital in middle-income countries in general.

Burden of COVID-19 Mortality and Morbidity in Poland in 2020.

In 2020 COVID-19 caused 41,442 deaths in Poland. We aimed to estimate the burden of COVID-19 using years of potential life lost (YPLL) and quality-adjusted years of life lost (QALYL). YPLL were calculated by multiplying the number of deaths due to COVID-19 in the analyzed age/sex group by the residual life expectancy for that group. Standard and country-specific (local) life tables were used to calculate SPYLL and LPYLL, respectively. QALYL were calculated adjusting LPYLL due to COVID-19 death by age/sex specific utility values. Deaths from COVID-19 in Poland in 2020 caused loss of 630,027 SPYLL, 436,361 LPYLL, and 270,572 QALYL. The loss was greater among men and rose with age reaching the maximum among men aged 65–69 and among women aged 70–74. Burden of COVID-19 in terms of YPLL is proportionate to external-cause deaths and was higher than the burden of disease in the respiratory system. Differential effects by sex and age indicate important heterogeneities in the mortality effects of COVID-19 and justifies policies based not only on age, but also on sex. Comparison with YPLL due to other diseases showed that mortality from COVID-19 represents a substantial burden on both society and on individuals in Poland.

Can a Greenhouse Gas Emissions Tax on Food also Be Healthy and Equitable? A Systemised Review and Modelling Study from Aotearoa New Zealand.

Policies to mitigate climate change are essential. The objective of this paper was to estimate the impact of greenhouse gas (GHG) food taxes and assess whether such a tax could also have health benefits in Aotearoa NZ. We undertook a systemised review on GHG food taxes to inform four tax scenarios, including one combined with a subsidy. These scenarios were modelled to estimate lifetime impacts on quality-adjusted health years (QALY), health inequities by ethnicity, GHG emissions, health system costs and food costs to the individual. Twenty-eight modelling studies on food tax policies were identified. Taxes resulted in decreased consumption of the targeted foods (e.g., −15.4% in beef/ruminant consumption, N = 12 studies) and an average decrease of 8.3% in GHG emissions (N = 19 studies). The “GHG weighted tax on all foods” scenario had the largest health gains and costs savings (455,800 QALYs and NZD 8.8 billion), followed by the tax—fruit and vegetable subsidy scenario (410,400 QALYs and NZD 6.4 billion). All scenarios were associated with reduced GHG emissions and higher age standardised per capita QALYs for Māori. Applying taxes that target foods with high GHG emissions has the potential to be effective for reducing GHG emissions and to result in co-benefits for population health.

Comparative economic evaluation of renal replacement therapies in Argentina, Costa Rica, and UruguayAvaliação econômica comparativa de terapias de substituição renal na Argentina, na Costa Rica e no Uruguai

RESUMENObjetivo.Evaluar las diferencias de costos y prevalencia de las terapias de remplazo renal (TRR) como el trasplante, la diálisis peritoneal y la hemodiálisis en Argentina, Costa Rica y Uruguay, mediante estrategias costo-efectivas de difusión.Métodos.Costos y prevalencia de principales financiadores y prestadores por país, y análisis de costo-efectividad mediante modelo de Markov a 5 años, evaluando estrategias de asignación de recursos expresadas por razón incremental de costo-efectividad en costo por año de vida ajustado por calidad.Resultados.Se observa dispersión entre los países en el acceso y los valores prestacionales de TRR, que afectan su prevalencia y el punto de equilibrio monetario. Desde el punto de vista de los costos, es más eficiente promover la realización de trasplantes y de diálisis peritoneal, y desalentar la indicación de hemodiálisis, aunque la disponibilidad de cada TRR por país requirió evaluaciones particulares.Conclusiones.Promover la realización de trasplantes ahorra costos, aunque los puntos de equilibrio variables requieren determinar diferentes umbrales de costo-efectividad por país. En Argentina y Uruguay, la administración de TRR mejoraría su eficiencia si se aumentan la cantidad de pacientes en diálisis peritoneal y las tasas de donación para trasplantes. En Costa Rica (donde hay tasas elevadas de trasplantes y margen presupuestario), la incorporación de técnicas dialíticas se ajusta por demanda e incidencia de pacientes con ERCT.

Cost-utility analysis of an implant treatment in dentistry

BackgroundWhen dealing with the replacement of one missing tooth, the patient has the option of choosing between different types of treatment interventions. Several important factors play a role in his decision-making process, including his limited financial means and his efforts to solve the problem of missing teeth as effectively as possible. The main goal of the study is the economic-clinical evaluation of implant treatment, as a surgical-prosthetic method in dentistry, in case of replacement of one missing tooth of the molar area.MethodsCost-utility analysis from the patient's perspective is used for evaluation. The selected comparator is a purely prosthetic solution with the help of a three-unit fixed dental prosthesis. Cost-utility analysis is modelled using Markov models, which consider a 30-year time horizon.ResultsBased on the results of modelling, the intervention evaluated by the patient, i.e. treatment with the help of implant-supported single crown, brings exactly 15.31 quality-adjusted prosthesis years (QAPY) after 30 years. The value of incremental cost-utility ratio amounted to USD − 1434.ConclusionThe results of the cost-utility analysis suggest that implant treatment with an implant-supported single crown is more cost-effective than treatment with the three-unit fixed dental prosthesis.

Assessing quality-adjusted years of life lost associated with exclusive cigarette smoking and smokeless tobacco use

The main purpose of this analysis is to quantify quality adjusted life years (QALYs) lost associated with lifetime exclusive cigarette or smokeless tobacco use among U.S. adults. Multiple waves of National Health Interview Survey (NHIS) data linked to death certificate records were used to define current exclusive cigarette and smokeless tobacco use and associated mortality risks. NHIS data were used to assess health-related quality of life (HRQOL). Regression and Cox proportional hazard modeling were used to adjust HRQOL and mortality risk associated with tobacco use for age, sex, race/ethnicity, body mass index, education, and household poverty level. QALYs were estimated based on adjusted HRQOL and mortality risks. All analyses were initiated in 2019 and completed in 2020. Male current exclusive cigarette smokers, aged 25 to 29 years would lose 8.1 QALYs (SE = 0.09), and male current exclusive smokeless tobacco users aged 25 to 34 would lose 4.1 QALYs (SE = 0.22), compared to never users of tobacco. Current exclusive cigarette or smokeless tobacco use is associated with QALY loss. QALYs lost can be lessened through preventing the initiation of tobacco product use or helping tobacco product users quit as early in life as possible.

False Economies: Myths about Public Health Spending

Coronavirus has raised questions about the use of public health resources in Britain. It has been argued that the government’s response was weakened by public health budget cuts and that public health expenditure saves money in the long run by reducing future healthcare costs. In reality, there has been no cut in Public Health England’s budget for infectious disease prevention. Between 2014 and 2019, its budget for protection from infectious diseases rose from £52 million to £86.9 million. Cutting the public health budget has been described as a false economy, but this is a misrepresentation. Most public health interventions are cost-effective if a quality-adjusted year of life is valued at £20,000, but only 20% of interventions save money or produce a cash return. More than a third of public health interventions would not be approved if they were NHS treatments because they are not cost-effective. It is not possible to tell from the available data whether England’s public health budget is too small, too large or about right, but many of the arguments made for increased spending on public health are based on a misunderstanding of economics and human behaviour.

Use of Quality-Adjusted Tooth Years as an Outcome Measure of Periodontal Treatment: A Quasi Experimental Study

Aim: To develop a simple approach to estimate quality-adjusted tooth years of teeth (QATY) treated for periodontitis and determine gains in QATY after undergoing cause-related periodontal therapy (CRPT). Quality-adjusted life years (QALY) gained for these patients were also determined. Materials and Methods: Patients newly diagnosed with periodontitis ( n = 165, 58.8% females, mean age 43.3 years) were recruited from periodontal specialist clinics. They received CRPT within a period of one year. We used the EuroQoL 5 Dimension (EQ-5D) and the Malaysian Oral Health Impact Profile (OHIP-14) indexes to measure changes in quality-of-life after one year of periodontal treatment. We then used these two scores to calculate their respective utilities and subsequently calculated QALY and QATY. Results: Proportions of deep periodontal sites (≥ 4 mm) decreased from 32.7% to 23.2% and patients gained an average of 0.3 mm of clinical attachment level per tooth at post-treatment follow-up. Improvements in means of OHIP-14 scores from 20.30 to 12.7 were consistent with changes in EQ-5D utilities from 0.81 to 0.91. Treated teeth gained 20.4 years for longevity while patients gained 17 QATYs. This is in line with the increase of 3.8 QALYs. Both treatment outcomes and clinical parameters were statistically significant at P < .0001. Conclusions: The method of estimating QATY using utilities derived from OHIP-14 combined with tooth life expectancy demonstrated that it may be used to measure effective treatment outcomes and is found to be consistent with improvements in QALY scores as calculated using EQ-5D-3L.

Economic evaluations in water-fluoridation: a scoping review

BackgroundCommunity water fluoridation (CWF) is considered one of the 10 greatest public health achievements of the twentieth century and has been a cornerstone strategies for the prevention and control of dental caries in many countries. However, for decision-makers the effectiveness and safety of any given intervention is not always sufficient to decide on the best option. Economic evaluations (EE) provide key information that managers weigh, alongside other evidence. This study reviews the relevant literature on EE in CWF.MethodsA systematic database search up to August 2019 was carried out using MEDLINE, EMBASE, Cochrane Library, LILACS, Paediatric Economic Database Evaluation and National Health Service Economic Evaluation Database. The review included full economic evaluations on CWF programs, written in English, Spanish or Portuguese. The selection process and data extraction were carried out by two researchers independently. A qualitative synthesis of the results was performed.ResultsOf 498 identified articles, 24 studies met the inclusion criteria; 11 corresponded to cost-benefit analysis; nine were cost-effectiveness analyses; and four cost-utility studies. Two cost-utility studies used Disability-Adjusted Life Years,, one used Quality-Adjusted Tooth Years, and another Quality-Adjusted Life Years. EEs were conducted in eight countries. All studies concluded that water fluoridation was a cost-effective strategy when it was compared with non-fluoridated communities, independently of the perspective, time horizon or discount rate applied. Four studies adopted a lifetime time horizon. The outcome measures included caries averted (n = 14) and savings cost of dental treatment (n = 4). Most of the studies reported a caries reduction effects between 25 and 40%.ConclusionFindings indicated that CWF represents an appropriate use of communities’ resources, using a range of economic evaluation methods and in different locations. These findings provide evidence to decision-makers which they could use as an aid to deciding on resource allocation.

The cost-utility of school-based first permanent molar sealants programs: a Markov model

BackgroundEvidence of the cost-effectiveness of school-based first permanent molar sealants programs is not yet fully conclusive. The aim of this study was to determine the incremental cost-utility ratio (ICUR) of school-based prevention programs for the application of sealants in molars of schoolchildren compared with non-intervention.MethodsA cost-utility analysis based on a Markov model was carried out using probability distribution. The utility was measured in quality-adjusted tooth years (QATY). The assessment was carried out from the public payer’s perspective with a six-year time horizon. Costs and benefits were discounted at 3% per year. Only direct costs were evaluated, expressed in Chilean pesos (CLP) at 7th May at 2019 values (exchange rate USD = CLP 681.09). Univariate deterministic sensitivity analysis and probabilistic analysis were carried out.ResultsAfter a six-year follow up, the cost of sealing all first permanent molars was found to be higher than non-intervention, with a mean cost difference of USD 1.28 (CLP 875) per molar treated. The “seal all” strategy was more effective than non-intervention, generating 0.2 quality-adjusted tooth years more than non-intervention. The ICUR of the “seal all” strategy compared to non-intervention was USD 6.48 (CLP 4,412) per quality-adjusted tooth years. The sensitivity analysis showed that the increase in caries was the variable which most influenced the ICUR.ConclusionsA school-based sealant program is a cost-effective measure in populations with a high prevalence of caries.

A Prospective Disease Registry of Patients with Mantle Cell Lymphoma Treated with Novel Agents: Treatment Patterns, Outcomes, and Patient-Reported Health-Related Quality of Life

A Prospective Disease Registry of Patients with Mantle Cell Lymphoma Treated with Novel Agents: Treatment Patterns, Outcomes, and Patient-Reported Health-Related Quality of Life

Concurrent chemoradiotherapy with nedaplatin versus cisplatin in stage II-IVB nasopharyngeal carcinoma: A cost-effectiveness analysis

BackgroundNedaplatin-based concurrent chemoradiotherapy became an alternative doublet treatment strategy to cisplatin-based concurrent chemoradiotherapy in patients with locoregional, advanced nasopharyngeal carcinoma. Materials and methodsUsing a Markov model, we simulated patients with nasopharyngeal carcinoma from disease-free to death. Input data for the model were collected from published literature and the standard fee database of West China Hospital. The outcome was expressed in quality-adjusted-years (QALYs), net monetary benefit at the threshold of $25,841, three times the Gross Domestic Product of China in 2017. The costs and benefits were discounted at 3% annually and a half-cycle correction was considered. The input parameters were varied in one-way sensitivity analysis to confirm the robustness of the model. All of the primary analyses used second-order probabilistic sensitivity analysis to capture the impact of parameter uncertainty based on 10,000 Monte-Carlo simulations. ResultsThe mean QALYs of treatment in stage II-IVB nasopharyngeal carcinoma were comparable: 2.90 QALYs for nedaplatin and 3.12 QALYs for cisplatin. Nedaplatin cost $34,505 compared with $27,167 for cisplatin, generating an incremental net monetary benefit of nedaplatin versus cisplatin of $-13,357 at the ceiling ratio of $25,841. The results of nedaplatin remained cost-ineffective over the majority of the sensitivity analyses. The cost-effectiveness curve showed that the probability of strategies being cost-effective were 0% for nedaplatin and 100% for cisplatin in stage II-IVB nasopharyngeal carcinoma at any willingness-to-pay threshold. ConclusionsNedaplatin is a dominated, cost-ineffective alternative to concurrent chemoradiotherapy in stage II-IVB nasopharyngeal carcinoma compared with cisplatin from the perspective of Chinese society.

Ocrelizumab – a monoclonal antibody – in the treatment of adult patients with multiple sclerosis: a systematic review

Aim: To analyze the efficacy, safety and pharmacoeconomic aspects of using ocrelizumab in adult patients with relapsing/remitting multiple sclerosis (R/R MS).Materials and Methods. We used the commonly accepted PICo(S) questionnaire with the following specifics: the population – patients with R/R MS; the intervention – ocrelizumab; the comparators – all disease-modifying treatments for MS; the outcomes – the annualized relapse rate, confirmed disability progression, MRI results, quality-adjusted years of survival (QALYs), adverse events, and other clinical outcomes. The search for the relevant information was conducted in 2018 by using the embase, PubMed, Cochrane and eLibrary.ru databases and the «ocrelizumab» AND «multiple sclerosis» keywords. The levels of evidence and conclusiveness of the cited studies were also assessed.Results. Treatments with ocrelizumab resulted in a lower rate of disease progression as compared with interferon β -1a. As evidenced by a randomized clinical trial, the annualized relapse rate estimated after 96 weeks was lower with ocrelizumab than that with interferon β-1a (0.16 vs. 0.29, 47% decrease, p<0.001). For most secondary end points, patients on ocrelizumab showed better outcomes than those on interferon β-1a. In the ocrelizumab group, the most common adverse events were caused by reactions to the drug infusion, nasopharyngitis, upper respiratory and urinary tract infections, and headaches. No cases of progressive multifocal leukoencephalopathy have been reported so far. ocrelizumab is more clinically effective than the first-line disease-modifying therapies; this conclusion also refers to patients with the aggressive (highly active) form of MS. ocrelizumab showed the efficacy similar to the second-line disease-modifying therapies, but it had a more favorable safety profile. The pharmacoeconomic indices showed that using ocrelizumab had a positive impact on the budget in the long-term perspective.Conclusions. ocrelizumab can be considered as the main treatment alternative for patients with highly active MS and patients with a high risk of progressive multifocal leukoencephalopathy. However, an additional assessment of the risk caused by rare adverse events is needed.

Cost-effectiveness of ovarian cancer screening: An analysis of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) from a U.S. health system perspective.

6608 Background: UKCTOCS is the largest randomized controlled trial to evaluate screening’s impact on ovarian cancer mortality, assigning women to multimodal screening (MMS) with serum CA125 interpreted with a risk algorithm; annual transvaginal ultrasound; or no screening (NS). There was a non-statistically significant 15% reduction in mortality over 11 years in MMS group. As most of the potential benefit of screening was seen after 7 years, follow-up is ongoing to determine if an observed stage shift translates into significant mortality reduction. The current study estimates the cost-effectiveness of an MMS screening program in the US. Methods: A modified Markov model was constructed using data from UKCTOCS to compare MMS to NS. Published estimates of the long term effect of MMS screening on ovarian cancer mortality were used to simulate mortality over 40 years from the start of screening. Base case costs included CA125, ultrasounds, clinical evaluations and false-positive surgeries, with an annual weighted cost of $35 in addition to an estimated risk algorithm cost of $100. The utility and costs of ovarian cancer treatment were incorporated into the model. Incremental cost-effectiveness ratios (ICERs) were calculated in 2016 U.S. dollars per quality-adjusted year of life saved (QALY). Additional sensitivity analyses were performed. Results: MMS is both more expensive and more effective in reducing ovarian cancer mortality over a lifetime than NS. Screening women from age 50 to 75 with MMS reduced mortality by 24% with an ICER of $98,062/QALY. If screening begins at age 60, MMS reduces mortality by 12%, with ICER below the willingness to pay threshold of $100,000/QALY only if the algorithm costs < $50. In probabilistic sensitivity analyses, the probability that screening from age 50-75 at an algorithm cost of $100 was less than $100,000/QALY was 41%. Conclusions: Ovarian cancer screening is potentially cost-effective in the US depending on final significance of mortality reduction and cost of the CA-125 risk algorithm. These results are limited by uncertainty around the effect of screening on ovarian cancer mortality beyond the 11 years of UKCTOCS.

De Novo Donor-Specific Human Leukocyte Antigen Antibody Screening in Kidney Transplant Recipients After the First Year Posttransplantation: A Medical Decision Analysis.

Screening for de novo donor-specific antibodies (dnDSA) in stable kidney transplant recipients is routine practice in some centers. Patients with DSA are at increased risk of graft loss and early intervention may improve outcomes. However, the costs and benefits of dnDSA surveillance are unknown. A medical decision analysis to examine a screening strategy was developed for kidney transplant recipients who had stable graft function and were DSA negative 1 year posttransplant. In the base case, a modest 25% reduction in graft loss in dnDSA-positive patients treated with increased immunosuppression resulted in 0.04618 quality-adjusted years (QALYs) gained. However, benefits from reduced graft loss were eliminated if there was a small increased risk of death from added therapy. The incremental cost effectiveness was marginal at approximately $120 000-250 000 per QALY, but could be more or less favorable depending on several key variables such as efficacy of treatment, screening costs, incidence rate of subclinical dnDSA, and patient survival. Screening performed the best in patients with lower mortality rates and higher baseline incidence rates of dnDSA. Further study is warranted to gather the necessary high-quality evidence to justify screening.

Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation in Taiwan

BackgroundEconomic evaluation of dabigatran, a new anti-antithrombotic agent, is done mostly in Western countries. It remains to be seen whether dabigatran will be cost effective in a practice environment where warfarin is significantly underused and the costs of both warfarin and international normalized ration INR monitoring are cheap. MethodsWe performed a cost-effectiveness analysis with a Markov model to evaluate the value of dabigatran to prevent stroke and systemic embolism in patients with atrial fibrillation (AF) in Taiwan. Dabigatran was given through sequential dosing, where patients<80years old received 150mg of dabigatran twice a day and the dosage was reduced to 110 mgs for patients≥80years old. Dabigatran was compared with warfarin under two scenarios: the “real-world adjusted-dose warfarin” assuming all AF patients eligible for warfarin were given the medication and maintained at the INR observed in routine clinical practice in Taiwan, and the “real-world prescribing behaviour” similar to the treatment with antithrombotics in real-world practice in Taiwan, where eligible patients could receive warfarin, aspirin, or no treatment. ResultsThe percentage of AF patients who received warfarin, aspirin or no treatment in Taiwan was 16%, 62% and 22%, respectively. The event rates of ischemic stroke per 100 patient-years were 4.5, 8.0, and 6.0 for sequential dabigatran, real-world prescribing behaviour and real-world warfarin use, respectively. The incremental cost-effectiveness ratio was $280 US per quality-adjusted-year (QALY) in the real-world prescribing scenario and $10,551 US/QALY in real-word warfarin use. ConclusionsDabigatran was highly cost-effective in a clinical practice setting where warfarin has been significantly underused.

Quality-adjusted tooth years (QATY) as an outcome measure of periodontal treatment

Background The use of quality-adjusted life years (QALY) as an outcome measure of economic evaluations is well-established in the literature. A measure of dental utility analogous to QALY, the quality-adjusted tooth years (QATY), had been initiated but only met with limited success, partly because of its inability to compare across a variety of dental interventions. This study aimed to develop a simple approach to estimate QATY by using an established oral health-related quality of life instrument.

Der QALY-Ansatz – Potentiale und Grenzen

The concept of quality-adjusted life expectancy ("quality-adjusted life years", QALY) is a type of cost-benefit analysis for health economic evaluation of treatment options. The two parameters quality of life and life expectancy are thereby combined into a single value - the QALY - which can shed light on the cost of therapy per additional quality-adjusted year of life. The concept is, however, widely used in ethical discussions of the adequacy of the generalizations on which this approach is based. Using the simulation of an American research team on treatment forms for prostate cancer, the QALY concept is explained, followed by the presentation of ethical criticisms.