Cost-utility analysis (FINAL)

utility

Is a quantitative expression of an individual’s preference for, or desirability of, a particular state of health under conditions of uncertainty

cost-utility analysis (CUA)

-A form of full economic evaluation

-Utility- or preference-adjusted outcomes (for example, QALY)

advantages of cost-utility analysis

-Different types of outcomes and diseases with multiple outcomes of interest can be compared using one common unit QALY—Quality-adjusted Life Years

-CUA incorporates morbidity and mortality into QALY without having to determine the monetary values of these health outcomes

Disadvantages of cost-utility analysis

-Determining utility is not an easy task

-QALY and CUA are not well-understood by providers or decision-makers

CEA

-Cannot compare programs of wide range of outcomes

-Outcomes expressed in the single natural units (disease or program-specific)

-Can evaluate intermediate outcomes

CUA

-Compare programs of wide range of outcomes

-Outcomes expressed as generic terms, such as QALYs

-Cannot evaluate intermediate outcomes

CBA

-Outcomes expressed in $$ units

-Compare among different programs (healthcare or non-healthcare)

CUA

-Outcomes expressed as gains in QALYs

-Compare among different healthcare interventions

steps in calculating QALYs

1.Develop a description of each disease state or condition of interest

2.Choose subjects who will determine utilities

3.Choose the method for determining utilities

-Direct measures of utilities

-Indirect measurement of utilities (utility measures of HRQoL)

4.Multiply utilities by the length of life for each treatement option to obtain QALYs

0.0

What is the worst imaginable health state on a rating scale?

1.0

What is the best imaginable health state on a rating scale?

standard gamble

the process used to determine utility values

-quality of well being scale

-health utility index

-EQ5D

What are indirect measurements of utility?

EQ-5D

-descriptive system

-health state valuations

-individual assessment of current health status

11111

What is an EQ-5D perfect health?

33333

What is an EQ-5D worst possible health?