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PharmacoEconomics

Erschienen in:

01.10.2003 | Current Opinion

Cost-effectiveness league tables

Valuable guidance for decision makers?

verfasst von: Dr Josephine Mauskopf, Frans Rutten, Warren Schonfeld

Erschienen in: PharmacoEconomics | Ausgabe 14/2003

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Abstract

This paper asks the question ‘are cost-effectiveness league tables a good way to provide information to decision makers about the value of new healthcare interventions?’ League tables that rank alternative healthcare interventions based on their incremental cost-effectiveness ratios (ICERs) are seen by economists as a valuable tool to inform decision makers about the allocation of scarce healthcare resources. However, league tables frequently compare ICERs from studies that have computed these ratios using different methods and assumptions including choice of comparator, choice of discount rate, time horizon, and population subgroup. The methodological differences among studies may influence the ranking of the studies and therefore decisions made using the league table. In addition, league tables generally do not include measures of the uncertainty of the cost-effectiveness estimates. In this paper, a reference case approach is proposed for the computation of the incremental cost-effectiveness ratio and an expanded set of measures is proposed for inclusion in the league table. In addition, a central repository for reference case expanded league tables is suggested so that decision makers can use them more effectively and more consistently.

Mason J. Cost-per-QALY leagues tables: their role in pharmacoeconomic analysis. Pharmacoeconomics 1994; 5 (6): 472–81PubMedCrossRef

Williams AH. Economics of coronary artery bypass grafting. BMJ 1985; 291: 326–9PubMedCrossRef

Torrance GW, Zipursky A. Cost-effectiveness of antepartum prevention of Rh immunization. Clin Perinatol 1984; 11: 267–81PubMed

Graham JD, Corso PS, Morris JM, et al. Evaluating the costeffectiveness of clinical and public health measures. Annu Rev Public Health 1998; 19: 125–52PubMedCrossRef

Pinkerton SD, Johnson-Masotti AP, Holtgrave DR, et al. Using cost-effectiveness league tables to compare interventions to prevent sexual transmission of HIV. AIDS 2001; 15: 17–28CrossRef

Lindholm L, Hallgren C, Boman K, et al. Cost-effectiveness analysis with defined budget: how to distribute resources for the prevention of cardiovascular disease. Health Policy 1999; 48: 155–70PubMedCrossRef

Moore RD, Bartlett JG. Combination antiretroviral therapy in HIV infection: an economic perspective. Pharmacoeconomics 1996; 10 (2): 109–13PubMedCrossRef

George B, Harris A, Mitchell A. Cost-effectiveness analysis and the consistency of decision making: evidence from pharmaceutical reimbursement in Australia (1991 to 1996). Pharmacoeconomics 2001; 19 (11): 1103–9PubMedCrossRef

Mason J, Drummond M, Torrance G. Some guidelines on the use of cost effectiveness league tables. BMJ 1993; 306: 570–2PubMedCrossRef

10.

Drummond M, Torrance G, Mason J. Cost-effectiveness league tables: more harm than good? Soc Sci Med 1993; 37: 33–40PubMedCrossRef

11.

Harris A, Buxton M, O’Brien B, et al. Using economic evidence in reimbursement decisions for health technologies: experience in 4 countries. Expert Rev Pharmacoeconomics Outcomes Res 2001; 1: 7–12CrossRef

12.

Gold MR, Siegal JA, Russell LB, et al., editors. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1996

13.

Pharoah P, Hollingworth W. Cost effectiveness of lowering cholesterol concentration with statins in patients with and without pre-existing coronary heart disease: life table method applied to health authority population. BMJ 1996; 312:1443-8

14.

Briggs A, Gray A. Using cost effectiveness information. BMJ 2000; 320: 246–8PubMedCrossRef

15.

Jacobson T, Schein J, Williamson A, et al. Maximizing the cost-effectiveness of lipid-lowering therapy. Arch Intern Med 1998; 158:1977–89PubMedCrossRef

16.

Chapman R, Stone P, Sandberg E, et al. A comprehensive league table of cost-utility ratios and a sub-table of “panelworthy” studies. Med Decis Making 2000; 20: 451–67PubMedCrossRef

17.

Simes R, Glasziou P. Meta-analysis and quality of evidence in the economic evaluation of drug trials. Pharmacoeconomics 1992; 1 (4): 282–92PubMedCrossRef

18.

Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17: 1–12PubMedCrossRef

19.

Murray CJL, Evans DB, Acharya A, et al. Development of WHO guidelines on generalised cost-effectiveness analysis. Health Econ 2000; 9: 235–51PubMedCrossRef

20.

Sendi P, Gafni A, Birch S. Opportunity costs and uncertainty in the economic evaluation of health care interventions. Health Econ 2002; 11: 23–32PubMedCrossRef

21.

Karlsson G, Johannesson M. The decision rules of cost-effectiveness analysis. Pharmacoeconomics 1996; 9 (2): 113–20PubMedCrossRef

22.

Bala M, Mauskopf J. The estimation and use of confidence intervals in economic analysis. Drug Inf J 1999; 33: 841–8CrossRef

23.

Hutubessy R, Baltussen R, Barendregt J, et al. Stochastic league tables: communicating cost-effectiveness results to decisionmakers. Health Economics 2001 Jul; 10 (5): 473–7PubMedCrossRef

24.

O’Brien B, Sculpher M. Building uncertainty into cost-effectiveness rankings: portfolio risk-return tradeoffs and implications for decision rules. Med Care 2000; 38: 460–8PubMedCrossRef

25.

Laupacis A, Feeny D, Detsky A, et al. How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evidence. CMAJ 1992; 146: 473–81PubMed

26.

Rutten F, van Busschbach J. How to define a basic package of health services for a tax funded or social insurance based health care system. Eur J Health Econ 2001; 2: 45–6CrossRef

Titel: Cost-effectiveness league tables
Valuable guidance for decision makers?
verfasst von: Dr Josephine Mauskopf
Frans Rutten
Warren Schonfeld
Publikationsdatum: 01.10.2003
Verlag: Springer International Publishing
Erschienen in: PharmacoEconomics / Ausgabe 14/2003
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI: https://doi.org/10.2165/00019053-200321140-00001

Springer Medizin

Abstract

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