Professional Documents
Culture Documents
From Wikipedia, the free encyclopedia Jump to: navigation, search Costutility analysis (CUA) is a form of financial analysis used to guide procurement decisions. The most common and well-known application of this analysis is in pharmacoeconomics, especially health technology assessment (HTA).
Contents
[hide]
1 CUA in health economics o 1.1 Advantages and disadvantages o 1.2 Criticism of cost-utility analysis 2 References 3 See also
relative patient or general population utility of a treatment or pharmacoeconomic intervention. Its results give no absolute indicator of the value of a certain treatment. The National Institute for Health and Clinical Excellence (NICE) is part of the National Health Service (NHS) in the UK and has been using QALYs to measure the health benefits delivered by various treatment regimens. There is some question as to how well coordinated NICE and NHS are in making decisions about resource allocation. According to a recent study cost effectiveness often does not appear to be the dominant consideration in decisions about resource allocation made elsewhere in the NHS.[1] While QALYs are used in the United States, they are not utilized to the same degree as they are in Europe. In the United Kingdom, as of January 2005, the (NICE) is believed to have a threshold of about 30,000 per QALY roughly twice the mean income after tax although a formal figure has never been made public [2] Thus, any health intervention which has an incremental cost of more than 30,000 per additional QALY gained is likely to be rejected and any intervention which has an incremental cost of less than or equal to 30,000 per extra QALY gained is likely to be accepted as cost-effective. This implies a value of a full life of about 2.4 million. In North America, a similar figure of US$50000 per QALY is often suggested as a threshold ICER for a cost-effective intervention. A complete compilation of costutility analyses in the peer reviewed medical literature is available at the CEA Registry Website
environment,[3] and the absence of incorporating the patients willingness to pay (i.e. behavioral economics) in decisions to finance new treatments.[4] Another criticism involves age; elderly individuals are assumed to have lower QALYs since they do not have as many years to influence the calculation of the measurement; so comparing a health interventions impact on a teenagers QALYs to an older individuals QALYs may not be considered fair since age is such an important factor. Specific health outcomes may also be difficult to quantify, thus making it difficult to compare all factors that may influence an individuals QALY. Example: Comparing an interventions impact on the livelihood of a single woman to a mother of three; QALYs do not take into account the importance that an individual person may have for others lives. In the US, the health care reform law (Patient Protection Affordability and Care Act) has forbiden the use of QALYs as a threshold to establish what type of health care is cost effective or recommended. Also, The Secretary shall not utilize such an adjusted life year (or such a similar measure) as a threshold to determine coverage, reimbursement, or incentive programs under title XVIII.[5][6]