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Estimating the Reference Incremental Cost-Effectiveness Ratio for the Australian Health System

PharmacoEconomics, 2018-02, Vol.36 (2), p.239-252 [Peer Reviewed Journal]

Springer International Publishing AG 2017 ;COPYRIGHT 2018 Springer ;Copyright Springer Nature B.V. Feb 2018 ;ISSN: 1170-7690 ;EISSN: 1179-2027 ;DOI: 10.1007/s40273-017-0585-2 ;PMID: 29273843

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Title:
Estimating the Reference Incremental Cost-Effectiveness Ratio for the Australian Health System
Author: Edney, Laura Catherine ; Haji Ali Afzali, Hossein ; Cheng, Terence Chai ; Karnon, Jonathan
Subjects: Age ; Budgets ; Cost analysis ; Cost benefit analysis ; Decision making ; Demographics ; Elasticity ; Estimates ; Evaluation ; Expenditures ; Funding ; Health Administration ; Health care expenditures ; Health care policy ; Health Economics ; Hospital costs ; Longitudinal studies ; Management ; Medical care, Cost of ; Medicine ; Medicine & Public Health ; Morbidity ; Mortality ; National government ; Opportunity costs ; Original Research Article ; Per capita ; Pharmaceuticals ; Pharmacoeconomics and Health Outcomes ; Population ; Public Health ; Quality of Life Research ; Technology ; Willingness to pay
Is Part Of: PharmacoEconomics, 2018-02, Vol.36 (2), p.239-252
Description: Background Spending on new healthcare technologies increases net population health when the benefits of a new technology are greater than their opportunity costs—the benefits of the best alternative use of the additional resources required to fund a new technology. Objective The objective of this study was to estimate the expected incremental cost per quality-adjusted life-year (QALY) gained of increased government health expenditure as an empirical estimate of the average opportunity costs of decisions to fund new health technologies. The estimated incremental cost-effectiveness ratio (ICER) is proposed as a reference ICER to inform value-based decision making in Australia. Methods Empirical top-down approaches were used to estimate the QALY effects of government health expenditure with respect to reduced mortality and morbidity. Instrumental variable two-stage least-squares regression was used to estimate the elasticity of mortality-related QALY losses to a marginal change in government health expenditure. Regression analysis of longitudinal survey data representative of the general population was used to isolate the effects of increased government health expenditure on morbidity-related, QALY gains. Clinical judgement informed the duration of health-related quality-of-life improvement from the annual increase in government health expenditure. Results The base-case reference ICER was estimated at AUD28,033 per QALY gained. Parametric uncertainty associated with the estimation of mortality- and morbidity-related QALYs generated a 95% confidence interval AUD20,758–37,667. Conclusion Recent public summary documents suggest new technologies with ICERs above AUD40,000 per QALY gained are recommended for public funding. The empirical reference ICER reported in this article suggests more QALYs could be gained if resources were allocated to other forms of health spending.
Publisher: Cham: Springer International Publishing
Language: English
Identifier: ISSN: 1170-7690
EISSN: 1179-2027
DOI: 10.1007/s40273-017-0585-2
PMID: 29273843
Source: ProQuest One Psychology
ProQuest Central

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Estimating the Reference Incremental Cost-Effectiveness Ratio for the Australian Health System

Springer International Publishing AG 2017 ;COPYRIGHT 2018 Springer ;Copyright Springer Nature B.V. Feb 2018 ;ISSN: 1170-7690 ;EISSN: 1179-2027 ;DOI: 10.1007/s40273-017-0585-2 ;PMID: 29273843

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