APPRAISING TOOLS

COST EFFECTIVE ANALYSIS (CEA)

This compares different technologies by considering not only the cost but also their effectiveness which is expressed in terms of physical one dimensional unit

COST EFFECTIVE ANALYSIS (CEA)

This technique is used to make a decision to select the most effective intervention from the available alternative.

COST EFFECTIVE ANALYSIS (CEA)

This is more commonly used pharmacoeconomic method

COST MINIMIZATION ANALYSIS (CMA)

A specific type of CEA That compares the cost per course of treatment when alternative therapies demonstrate the same clinical effectiveness

COST MINIMIZATION ANALYSIS (CMA)

The cost associated with each intervention may be compared; this consist of selecting the cheapest option

COST MINIMIZATION ANALYSIS (CMA)

Example is the cost comparison of two ARBs which successfully produce similar blood pressure pattern in

selected group of patients.

COST UTILITY ANALYSIS (CUA)

This compares different technologies by considering both costs and effectiveness

COST UTILITY ANALYSIS (CUA)

The effectiveness is expressed in terms of quality-adjusted life years (QALYs)

QALY includes both improvements in the quantity and quality of life

multiplying the utility value obtained for the specific health condition with the quantity of life year spent in that specific health condition

QALY is calculated by

QALY

This comparison can be made for program and intervention.

• The outcome measured is cost per QALY

QALY

focuses on all aspects of life

Is equal to living for one year in perfect health

COST BENEFIT ANALYSIS (CBA)

This is a basic tool that helps in improving the decision-making process in a healthcare program

COST-BENEFIT ANALYSIS (CBA)

This method assesses both cost and effectiveness of each alternative in monetary terms expressed in dollar value

COST BENEFIT ANALYSIS (CBA)

This method calculates all of the possible benefits that may occur from the program

COST OF ILLNESS ANALYSIS (COI)

This identifies measure and quantifies only disease-related cause but this does not include the related effects

COST OF ILLNESS ANALYSIS (COI)

This does not address both cost and consequences

COST OF ILLNESS ANALYSIS (COI)

This is important in the evaluation of new therapies

COST-BENEFIT ANALYSIS (CBA)

All effect measured in dollars

COST-BENEFIT ANALYSIS (CBA)

Strengths

- The net benefit (NB) is easy to interpret. For examples, a new treatment’s extra benefits are worth more than the extra costs when NB > 0

COST-BENEFIT ANALYSIS (CBA)

Limitations

- It is difficult to measure the value of all health outcomes in dollars. There may be moral objections about the impact of ability to pay in the process of valuing the effects

COST-UTILITY ANALYSIS (CUA)

Measurement units for effects:

Two effects (quality and length of life) whose product is taken as quality adjusted life years (QALYs)

COST UTILITY ANALYSIS (CUA)

Strengths

Patient outcomes involving both quality and length of life can be incorporated in the analysis

COST-UTILITY ANALYSIS (CUA)

Strengths

In theory, the QALY measure is “universal” so that very different programs evaluated with QALYs can be compared

COST-UTILITY ANALYSIS (CUA)

Limitations

- QALY measure vary by method

- QALY measure vary by respondents

COST-UTILITY ANALYSIS (CUA)

Limitations

Society may value a QALY for different patient groups differently (for example, is a QALY gained for sufferers of erectile dysfunction valued the same as a QALY gained for sufferers of severe mental illness)

COST-EFFECTIVENESS ANALYSIS (CEA)

Measurement units for effects:

- One effect measured in “natural units”

COST-EFFECTIVENESS ANALYSIS (CEA)

Strengths

- There is one outcome and it is measured in its “natural units”

COST EFFECTIVENESS ANALYSIS (CEA)

Limitations

- Only one outcome will represent the effect of treatment, however, other outcomes may be relevant

COST – MINIMIZATION ANALYSIS (CMA)

Measurement units for effects:

- No effects measured

COST – MINIMIZATION ANALYSIS (CMA)

Strengths

- There is only a need to collect cost data

COST – MINIMIZATION ANALYSIS (CMA)

Limitations

- Few treatments have identical outcomes.

COST – MINIMIZATION ANALYSIS (CMA)

Limitations

Researchers would likely need to collect the effect data to verify the “equal effect” assumption