Use Of Cost-effectiveness Analyses Research Articles

Response to Letter to the Editor: The Use of Cost-effectiveness Analyses in Open-Angle Glaucoma Management: A Systematic Review of the Current Literature.

Response to Letter to the Editor: The Use of Cost-effectiveness Analyses in Open-Angle Glaucoma Management: A Systematic Review of the Current Literature.

Time to publication of cost-effectiveness analyses for medical devices.

Academic researchers and physicians have called for greater use of cost-effectiveness analyses in informing treatment and reimbursement decisions. This study examines the availability of cost-effectiveness analyses for medical devices, in terms of both the number of studies and when studies are published. Analysis of the number of years between FDA approval/clearance and publication for cost-effectiveness analyses of medical devices in the United States published between 2002 and 2020 (n = 86). Cost-effectiveness analyses of medical devices were identified using the Tufts University Cost-Effectiveness Analysis Registry. Studies in which the model and manufacturer of the medical device used in the intervention were identifiable were linked to FDA databases. Years between FDA approval/clearance and publication of cost-effectiveness analyses were calculated. A total of 218 cost-effectiveness analyses of medical devices in the United States published between 2002 and 2020 were identified. Of these studies, 86 (39.4%) were linked to FDA databases. Studies examining devices approved via premarket approval were published a mean of 6.0 years after the device received FDA approval (median, 4 years), whereas studies examining devices that were cleared via the 510(k) process were published a mean of 6.5 years after the device received FDA clearance (median, 5 years). There are few studies describing the cost-effectiveness of medical devices. Most of these studies' findings are not published until several years after the studied devices received FDA approval/clearance, meaning that decision makers will likely not have evidence of cost-effectiveness when making initial decisions related to newly available medical devices.

Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine.

Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years. To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses. The intended audiences include researchers, government policy makers, public health officials, health care administrators, payers, businesses, clinicians, patients, and consumers. In 2012, the Second Panel on Cost-Effectiveness in Health and Medicine was formed and included 2 co-chairs, 13 members, and 3 additional members of a leadership group. These members were selected on the basis of their experience in the field to provide broad expertise in the design, conduct, and use of cost-effectiveness analyses. Over the next 3.5 years, the panel developed recommendations by consensus. These recommendations were then reviewed by invited external reviewers and through a public posting process. The concept of a "reference case" and a set of standard methodological practices that all cost-effectiveness analyses should follow to improve quality and comparability are recommended. All cost-effectiveness analyses should report 2 reference case analyses: one based on a health care sector perspective and another based on a societal perspective. The use of an "impact inventory," which is a structured table that contains consequences (both inside and outside the formal health care sector), intended to clarify the scope and boundaries of the 2 reference case analyses is also recommended. This special communication reviews these recommendations and others concerning the estimation of the consequences of interventions, the valuation of health outcomes, and the reporting of cost-effectiveness analyses. The Second Panel reviewed the current status of the field of cost-effectiveness analysis and developed a new set of recommendations. Major changes include the recommendation to perform analyses from 2 reference case perspectives and to provide an impact inventory to clarify included consequences.

Evaluating the administration costs of biologic drugs: development of a cost algorithm.

Biologic drugs, as with all other medical technologies, are subject to a number of regulatory, marketing, reimbursement (financing) and other demand-restricting hurdles applied by healthcare payers. One example is the routine use of cost-effectiveness analyses or health technology assessments to determine which medical technologies offer value-for-money. The manner in which these assessments are conducted suggests that, holding all else equal, the economic value of biologic drugs may be determined by how much is spent on administering these drugs or trade-offs between drug acquisition and administration costs. Yet, on the supply-side, it seems very little attention is given to how manufacturing and formulation choices affect healthcare delivery costs. This paper evaluates variations in the administration costs of biologic drugs, taking care to ensure consistent inclusion of all relevant cost resources. From this, it develops a regression-based algorithm with which manufacturers could possibly predict, during process development, how their manufacturing and formulation choices may impact on the healthcare delivery costs of their products.Electronic supplementary materialThe online version of this article (doi:10.1186/s13561-014-0026-2) contains supplementary material, which is available to authorized users.

Beyond methods and studies: Building institutions for better public spending on vaccination

While overall public spending on health as a percentage of GDPremains relativelylow,astheireconomiesgrow,mostgovernmentsin Latin America and the Caribbean (LAC) are spending more perperson on health care and public health. In the area of vaccines,public spendinghasalsogrown;between2010and2011alone,theWorld Health Organization (WHO) estimated that public spend-ing on vaccination in LAC grew by 15% on average [1], althoughthere isconsiderableheterogeneityinpercapitaspendingbetweencountries.In many ways, LAC has been and remains a leader in vaccineintroduction relative to other regions. Even so and in spite ofincreasing spending overall and global evidence on the potentialvalue of new and underutilized vaccines [2], there is uneven con-sideration and adoption of new vaccines. As of 2012, less than halfof the 48 LAC countries and territories have adopted the Rotavirusvaccine, 21 countries and 5 territories have adopted the pneumo-coccal vaccine, and six countries have adopted HPV as part of theirnational immunization programs [3].Many LAC governments have established WHO-recommendedNational Immunization Technical Advisory Groups (NITAG) toadvise on new vaccine adoption and the national immunizationprogram ingeneral[4].Inspiteoftheseefforts,Andrusetal.identi-fied instances of decision making without reference to availableevidence, limited use of cost-effectiveness analyses in decisionmaking, and limited technical capacity to carry out economic eval-uation [5]. Further, a 2008 report of the independent Commissionon the Future of Vaccines in Latin America also noted the absenceof cost-effectiveness analyses using national data, information oncosts and risk groups for specific preventable diseases, and disag-gregated data on local and municipal levels as major obstacles tobetter priority-setting for vaccines [6].

Quality-adjusted life years in cancer: pros, cons, and alternatives

High and rising cancer treatment costs have forced a discussion about the use of cost-effectiveness analyses and other approaches to assess the value of cancer care. Oncologists have traditionally resisted using economic considerations in day-to-day medical considerations, though unavoidably their decisions have important resource implications, and increasingly economic realities are impacting their actions. In this paper, we summarise the use of the quality-adjusted life years to assess the value of cancer care and suggest potential ways to improve upon value measurement in cancer coverage and reimbursement decisions.

Perspectives on Cost‐effective Medicine and the Use of Cost‐effectiveness Analyses

Perspectives on Cost‐effective Medicine and the Use of Cost‐effectiveness Analyses

European reforms urged to reduce differential drug costs between nations

Policies to promote more extensive use of generic pharmaceuticals, better prescribing by physicians and more widespread use of cost-effectiveness analyses in the selection of drugs for national formularies are among measures that would reduce current variations in the price of drugs across Europe,

Cost-effectiveness of antihypertensive agents in patients with reduced left ventricular function.

A pharmacoeconomic primer reviews current economic models used to analyze and synthesize information that may be considered in certain health-related policies or clinical decisions. Heightened budgetary pressures concomitant with mandates for demonstrable increases in efficacy and safety have fostered greater use of cost-effectiveness analyses (CEAs) throughout the health care industry. In the field of hypertension, major clinical trials of pharmacotherapeutic regimens generally demonstrated benefit of reducing blood pressure; CEAs supplied additional data concerning the optimum selection among alternative antihypertensive therapies. As interest has focused on the preservation of left ventricular (LV) function for the best prognosis, it has become increasingly evident that not all antihypertensive regimens affect LV function in the same way. Thus CEA may be an appropriate method to evaluate these effects and facilitate the identification of a regimen that minimizes deterioration of LV function.

The Use of Cost-Effectiveness Analyses at a Federal Public Health Agency

Decision and economic analytic techniques, including benefit-cost and cost-effectiveness analysis, are being used and appreciated increasingly in public health in general and at the primary federal agency for public health and disease prevention, the Centers for Disease Control (CDC), in particular. This article describes the frequency and breadth of economic analyses at the CDC. The uses of such analyses include: justifying existing programs; promoting successful programs for more widespread acceptance; assisting in difficult decision making; assessing the need to change current policy; and aiding in determining the most appropriate use of a technology.