Economic evaluation

Question 1

Cost-effectiveness Analysis (CEA)

Answer 1

Compares a number of interventions by relating costs to a single clinical measure of effectiveness (e.g. symptom reduction, improvement in activities of daily living).

CEA = total cost / units of effectivness

Usually done when CBA is unable to be performed due to inability to monetise benefits

Reported as ICER (costs A - costs B)/(effects A - effects B))

Question 2

Cost Benefit Analysis (CBA)

Answer 2

All the costs and benefits are measured in terms of money - used to establish which alternative has the greatest net benefit

Life-saved years, SE, symptom relief, disability, pain + discomfort allocated a monetary value

Rarely used

Question 3

Cost Utility Analysis (CUA)

Answer 3

Benefits / outcomes are broader, more generic ways

Measured by a single preference or utility based index e.g. QALY

1 QALY = 1 year of life in perfect health

Able to compare treatments for different conditions (cannot do this with CEA)

ICUR = (costs A - costs B)/(QALYs gained by A - QALYs gained by B))

Question 4

Cost Minimisation Analysis (CMA)

Answer 4

Consequences of competing interventions are the same and in which only inputs, that is, costs are taken into consideration. The aim is to decide the least costly way of achieving the same outcome.

Question 5

Costs - direct

Answer 5

Associated directly with the healthcare intervention (e.g. staff time, medical supplies, cost of travel for the patient, childcare costs for the patient, costs falling on other social sectors such as domestic help from social services)

Question 6

Costs - indirect

Answer 6

Incurred by the reduced productivity of the patient (e.g. time of work, reduced work productivity, time spent caring for the patient by relatives)

Question 7

Costs - intangibable

Answer 7

Difficult to measure (e.g. pain or suffering on the part of the patient)