Cost Utility Analysis Flashcards
a holistic concept that is determined by more than the presence or absence of disease, includes more like mental wellbeing, physical illness and measures of functioning.
Health status
_____________________(QALY)
-a year of life lived in perfect health
-a measure of person’s length of life weighted by a valuation of their health related quality of life
Quality Adjusted Life year (QALY)
1 QALY is 1 year of perfect health (0=_______, 1=___________)
▪ to calculate, multiply years of life by fraction of health state
0=dead
1=perfect health
Calculation of quality adjusted life year
Intervention A: 4 years in health state 0.75
4 X 0.75 = 3 QALY
Comparing QALYs, do (Cost A-Cost B) / (QALY A – QALY B)
example:
Option A costs $5000 and extends life for 6 years at a quality of 0.8 and option B costs $4000 and extends life for 10 years at a quality of 0.3
(5000 – 4000) / [(6 times 0.8) – (10 times 0.3)] = 555.6
Cost-Utility Analysis (CUA)
costs are measured in dollars and consequences (outcomes, effectiveness) are measured using patient utility (values, preferences)
They incorporate _________and _________ (quality and quantity of life)
mortality and morbidity
When Should CUA Be Used?
o When quality of life is the only ____________
o When quality and quantity of life are __________________
outcome
health outcomes
When Should CUA Be Used?
When treatments affect both __________ and ___________
When treatments have a large range of outcomes with a need for a common unit of outcome
When the objective is to compare with another intervention that already measures outcomes in QALYS.
mortality and morbidity
Measuring Utility (Value Preference)
▪ Rating Scales:
* Endpoints are dead/healthy
* Other health states are explained and subjects are asked to rate them between two endpoints
* May look like a thermometer
* it is possible to compare many health state options and ask raters to place them on a scale
* A value of 1 is perfect health and a value of 0 is death
o 0.0 – ______
o 0.33 – hospital confinement
o 0.56 – hospital dialysis (public)
o 0.58 – hospital dialysis (pts)
o 0.84 – kidney transplants
o 1.0 – perfect health
0.0=dead
When May CUA(cost utility analysis) NOT Needed?
o When interested only in __________ outcomes
o When treatments have _______effectiveness
o When costs associated with obtaining utility measures is judged to be “_______________”
intermediate
similar
not be cost effective
___________:
- the participants are asked the amount of time they would be willing to give up to achieve a better health state.
Time trade-off (TTO)
________________________ (TTO)
utility score = X(lifespan in perfect health) / t(lifespan with the disease)
Time trade off
_________________________
Subjects are offered two alternatives,
-state i for time t followed by death
-health time x (less than t) followed by death
-(basically being in a less healthy state for a longer amount of
time or a healthy state for a lesser amount of time)
Time trade off (TTO)
________________________
Helps measure the extent of health gain that results from a health intervention
Quality adjusted life years (QAL)
Intervention A: 4
years in health state
0.75: 3 QALY
(4*0.75)
