Cost effectiveness analysis Powerpoint Presentation

Cost effectiveness analysis

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Slide 1 :

11/24/2010 2:00 AM © Cordis Johnson & Johnson Slide 1 Cost effectiveness Analysis: Steve Fearn PhD Cordis …. a Dark Art? Informing health policy or….

Slide 2 :

Cost effectiveness The language of NICE. Compare the value of different treatments for the same condition (eg. BMS vs DES). Costs Initial procedure (incl. DES) Follow up (repeat revascs, MI, death) Effects Expressed in terms of quality-adjusted life years (QALYs) Recurrence of angina and repeat revascularisation causes loss of QALYs. ? TLR = ? QALYs

Slide 3 :

Source Data Brophy JM, Belisle P, Joseph L (2003). Evidence for Use of Coronary Stents. Ann Intern Med. 138:777-786. NNT = 18

Slide 4 :

Comparing Costs and Effects Effect (QALY) Cost 0 = comparator e.g. BMS Dominated Dominant 0 = incremental cost effectiveness ratio (ICER) (the cost of buying 1 extra QALY)

Slide 5 :

What Constitutes Good Value? NICE denies having a threshold, but £20,000 - £30,000 per QALY gained is the working range. >£30,000 per QALY: society should spend healthcare £ elsewhere.

Slide 6 :

Cost effectiveness For Common language Threshold for decision making. Reflects value, not just cost. Foundation is clinical data. Against Not easily understood What is the threshold for good value? What about budget impact? Can choose to ignore data we don’t want to accept. Hawkins N, Sculpher M, Rothman M (2005). Modelling the cost-effectiveness of cardiac interventions: the case of sirolimus-eluting stents. Br J Cardiol (Acute Interv Cardiol):12:AIC 83–AIC 91. Hawkins N, Sculpher M (2005). Evaluating the cost-effectiveness of drug-eluting coronary stents: the results of a Bayesian evidence synthesis and decision model. Society of Medical Decision Making. http://smdm.confex.com/smdm/2005ca/techprogram/P2364.HTM.

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