Difference between revisions of "Economic evaluation"

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== Question ==  
 
== Question ==  
  
If a vaccine product is more effective, but also more expensive, when are the additional benefits worth the excess cost?
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Are the incremental health effects worth the incremental costs, if a vaccine is both more effective and more expensive?  
* The benefits are assessed from the decrease of cases of pnaumococcal deseases following the extensive use of the vaccine. Benefit (effectiveness) is measured in Quality-Adjusted Life Years (QALYs)
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*The health benefit of the national infant immunisation programme is assessed by the expected reduction in the annual number of invasive pneumococcal disease in the Finnish population. The health benefit or effectiveness is measured in Quality-Adjusted Life Years (QALYs).
* Health care costs are the only costs taken into account.
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*The perspective of this analysis is the health care provider.  
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== Answer ==
 
== Answer ==
  
To find the most cost-effective product according to the crieria described in the rationale.
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To find the most cost-effective vaccine according to the crieria described in the rationale.
  
 
== Rationale ==  
 
== Rationale ==  
  
Products are arranged accordin to effectiveness (V<sub>1</sub> < V<sub>2</sub> < V<sub>3</sub>, etc.). With the product's incremental cost-effectiveness ratio (ICER; unit €/QALY) the product's effectiveness is comaperd to the next more effective product. ICER is calculated by dividing the difference between costs with the difference between health effects:
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Vaccines are ranked according to their effectiveness (V1 < V2 < V3, etc.). Vaccines that are more expensive and less effective compared with at least one other alternative (strongly dominated) are excluded. Incremental cost-effectiveness ratios (ICER) are calculated for the remaining vaccines:
  
 
<math>ICER = \frac{(C_2-S_2) - (C_1-S_1)}{E_2-E_1},</math>
 
<math>ICER = \frac{(C_2-S_2) - (C_1-S_1)}{E_2-E_1},</math>
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  where C is the prize of the vaccinating progranm, S is the savings in health care costs and E is the savings on QALY.
 
  where C is the prize of the vaccinating progranm, S is the savings in health care costs and E is the savings on QALY.
  
The more effective and more expensive product (V<sub>2</sub>) is chosen, if the decision makers think the additional effectiveness is worth the excess cost, meaning ICER < acceptable marginal cost.
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Each vaccine (ranked according to their effectiveness) is compared with the next highest ranked vaccine. The least effective vaccine is compared with doing nothing. The most cost-effective vaccine is chosen.  
  
 
== See also ==
 
== See also ==
  
 
{{pneumococcal vaccine}}
 
{{pneumococcal vaccine}}

Revision as of 09:43, 25 June 2014

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Question

Are the incremental health effects worth the incremental costs, if a vaccine is both more effective and more expensive?

  • The health benefit of the national infant immunisation programme is assessed by the expected reduction in the annual number of invasive pneumococcal disease in the Finnish population. The health benefit or effectiveness is measured in Quality-Adjusted Life Years (QALYs).
  • The perspective of this analysis is the health care provider.


Answer

To find the most cost-effective vaccine according to the crieria described in the rationale.

Rationale

Vaccines are ranked according to their effectiveness (V1 < V2 < V3, etc.). Vaccines that are more expensive and less effective compared with at least one other alternative (strongly dominated) are excluded. Incremental cost-effectiveness ratios (ICER) are calculated for the remaining vaccines:

Failed to parse (Missing <code>texvc</code> executable. Please see math/README to configure.): ICER = \frac{(C_2-S_2) - (C_1-S_1)}{E_2-E_1},

where C is the prize of the vaccinating progranm, S is the savings in health care costs and E is the savings on QALY.

Each vaccine (ranked according to their effectiveness) is compared with the next highest ranked vaccine. The least effective vaccine is compared with doing nothing. The most cost-effective vaccine is chosen.

See also

Tendering process for pneumococcal conjugate vaccine
Parts of the assessment

Comparison criteria for vaccine   · Epidemiological modelling   · Economic evaluation

Background information

Sensitivity analysis · Replacement   · Pneumococcal vaccine products   · Finnish vaccination schedule   · Selected recent publications


Help for discussion and wiki editing

Pages in Finnish

Pneumokokkirokotteen hankinta  · Rokotteen vertailuperusteet · Epidemiologinen malli · Taloudellinen arviointi · Pneumokokkirokotteen turvallisuus


Work scheduling · Monitoring the effectiveness of the pneumococcal conjugate vaccine · Glossary of vaccine terminology