Quality-Adjusted Life Years: A measurement index derived from a modification of standard life-table procedures and designed to take account of the quality as well as the duration of survival. This index can be used in assessing the outcome of health care procedures or services. (BIOETHICS Thesaurus, 1994)Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.Markov Chains: A stochastic process such that the conditional probability distribution for a state at any future instant, given the present state, is unaffected by any additional knowledge of the past history of the system.Models, Economic: Statistical models of the production, distribution, and consumption of goods and services, as well as of financial considerations. For the application of statistics to the testing and quantifying of economic theories MODELS, ECONOMETRIC is available.Decision Support Techniques: Mathematical or statistical procedures used as aids in making a decision. They are frequently used in medical decision-making.Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.Decision Trees: A graphic device used in decision analysis, series of decision options are represented as branches (hierarchical).Life Expectancy: Based on known statistical data, the number of years which any person of a given age may reasonably expected to live.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Drug Costs: The amount that a health care institution or organization pays for its drugs. It is one component of the final price that is charged to the consumer (FEES, PHARMACEUTICAL or PRESCRIPTION FEES).Models, Econometric: The application of mathematical formulas and statistical techniques to the testing and quantifying of economic theories and the solution of economic problems.Cost of Illness: The personal cost of acute or chronic disease. The cost to the patient may be an economic, social, or psychological cost or personal loss to self, family, or immediate community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, or QUALITY OF LIFE. It differs from HEALTH CARE COSTS, meaning the societal cost of providing services related to the delivery of health care, rather than personal impact on individuals.Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Monte Carlo Method: In statistics, a technique for numerically approximating the solution of a mathematical problem by studying the distribution of some random variable, often generated by a computer. The name alludes to the randomness characteristic of the games of chance played at the gambling casinos in Monte Carlo. (From Random House Unabridged Dictionary, 2d ed, 1993)Sensitivity and Specificity: Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.United StatesOutcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Great BritainModels, Statistical: Statistical formulations or analyses which, when applied to data and found to fit the data, are then used to verify the assumptions and parameters used in the analysis. Examples of statistical models are the linear model, binomial model, polynomial model, two-parameter model, etc.Models, Theoretical: Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment.Value of Life: The intrinsic moral worth ascribed to a living being. (Bioethics Thesaurus)Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes.Stroke: A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Health Status Indicators: The measurement of the health status for a given population using a variety of indices, including morbidity, mortality, and available health resources.Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis.HIV Infections: Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS).Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.

*  Lifetime Costs and Quality-Adjusted Life Years Saved From HI... : JAIDS Journal of Acquired Immune Deficiency Syndromes

Lifetime Costs and Quality-Adjusted Life Years Saved From HIV Prevention in the Test and Treat Era. Farnham, Paul G. PhD*; ... Home , October 1, 2013 - Volume 64 - Issue 2 , Lifetime Costs and Quality-Adjusted Life Years Saved From HI... ... Lifetime Costs and Quality-Adjusted Life Years Saved From HIV Prevention in the Test and Treat Era ...

*  Discrete choice experiments (DCEs) to inform pharmacy policy: going beyond Quality Adjusted Life Years (QALYs) - LSE Research...

Discrete choice experiments (DCEs) to inform pharmacy policy: going beyond Quality Adjusted Life Years (QALYs) ... going beyond Quality Adjusted Life Years (QALYs). In: Third Conjoint Analysis in Health Conference, 5th-7th October 2010, ...

*  "Cost-effectiveness of transesophageal echocardiography to determine the duration of therapy for intravascular catheter...

4938 per quality-adjusted life-year (QALY) gained. The effectiveness of the TEE strategy and the effectiveness of the long- ... OUTCOME MEASURES: Quality-adjusted life expectancy, costs, and incremental cost-effectiveness ratios. RESULTS OF BASE-CASE ... 4938 per quality-adjusted life-year (QALY) gained. The effectiveness of the TEE strategy and the effectiveness of the long- ... Quality-Adjusted Life Years; Sensitivity and Specificity; Staphylococcal Infections ...

*  WSJ: What's your view on government-mandated health-care coverage?

Rawlins: It's based on the cost of a measure called the 'quality-adjusted life year.' A QALY scores your health on a scale from ... And .2 times 15 equals three quality-adjusted life years. If the hip replacement costs 10,000 GBP [about $15,000] to do, it's ... If your care exceeds that amount in a year, you get cut off. If you have a life-threatening illness, then bye-bye. And as we ... Rawlins was asked by the interviewer, 'You are basically deciding how much a year of life is worth?' He agreed, admitting that ...

*  Hepatitis A Vaccine Recommendations | FROM THE AMERICAN ACADEMY OF PEDIATRICS | Pediatrics

173000 per life-year gained and $24000 per quality-adjusted life-year (QALY) gained. When out-of-cohort herd immunity was ... QALY-quality-adjusted life-year. REFERENCES. *↵. Armstrong GL, Bell BP. Hepatitis A virus infections in the United States: ... one for use in children 12 months to 18 years of age and another for use in individuals 19 years of age and older. Twinrix ... All children who live in the United States should receive hepatitis A vaccine at 1 year of age (ie, 12-23 months of age) as a 2 ...

*  Cost-Effectiveness of Providing Full Drug Coverage to Increase Medication Adherence in Post-Myocardial Infarction Medicare...

We discounted quality-adjusted life-years (QALYs) and future costs at a rate of 3%. Our base-case analysis was conducted from ... From the standpoint of Medicare, full drug coverage was highly cost-effective ($7182/quality-adjusted life-year) but not cost ... 7182/quality-adjusted life-year) but not cost saving.. Conclusions- Our analysis suggests that providing full coverage for ... 0.35 quality-adjusted life-year) and less resource use ($2500). From the perspective of Medicare, full drug coverage was highly ...

*  Masters Degrees (Vaccines)

Which biomarkers predict for quality adjusted life years? As a graduate you will be eligible for many PhD programmes and be ... School of Life Sciences Are you a recent graduate, scientist, engineer or manager looking to develop your professional skills ... MSc Molecular Life Sciences MSc Food Technology MSc Bioinformatics MSc Plant Biotechnology MSc Environmental Sciences. Read ... Life Sciences Biotechnology is defined as the industrial exploitation of living organisms or the exploitation of components ...

*  DSM staff profile

... personal spending and quality-adjusted life years lost. Injury Prevention, 19(2), 124-129. doi: 10.1136/injuryprev-2011-040252 ... Morgaine, K., Langley, J. D., & McGee, R. O. (2006). The FarmSafe Programme in New Zealand: Process evaluation of year one ( ... Langley, J. D., Davie, G. S., & Simpson, J. C. (2007). Quality of hospital discharge data for injury prevention. Injury ... Cryer, C., Samaranayaka, A., Langley, J. D., & Davie, G. (2014). The epidemiology of life-threatening work-related injury: A ...

*  Health-related quality of life associated with daytime and nocturnal hypoglycaemic events: a time trade-off survey in five...

It builds on PubMed Central (PMC), the U.S. National Institutes of Health (NIH) free digital archive of biomedical and life ... peer-reviewed health and life sciences research publications. ... Torrance GW, Feeny D. Utilities and quality-adjusted life years ... Health-related quality of life; MID: Minimally important difference; QALY: Quality-adjusted life-year; TTO: Time trade-off. ... and under certain assumptions can be used to estimate quality-adjusted life-years (QALYs) [19,20]. For example, in a guide to ...

*  Ethics professor inspires $100 million of charitable donations - The Oxford Student

Instead GWWC uses the metric of "quality adjusted life years" (QALYs). By measuring the number of years of healthy life that a ... 31,000 per year on average for the rest of their career, could provide 3,982 years of healthy life and 73,005 years of school ... The current level of pledges can save four million years of healthy life, according to Dr Ord. This is an impressive number, ... 50,000 years of life versus a larger house etc)," said Ord, "I decided I would make a pledge to donate a large part of my ...

*  HE608: Economic Evaluation and Financing of Health Care - Institute of Health Economics

Cost utility analysis: what is cost utility analysis? when we should conduct cost utility analysis? differences between cost effectiveness analysis and cost utility analysis, measuring health outcomes under cost utility ...

*  IJERPH | Free Full-Text | Setting the Research Agenda on the Health Effects of Chemicals | HTML

In 2011, World Health Organization (WHO) scientists reported that a significant percentage of global deaths and disability-adjusted life years (DALYs) in 2004 could be attributed to chemicals. The 2011 review focused only on certain chemicals, however, and concluded that the global burden of disease was underestimated because of serious data gaps. While various chemical assessment documents have identified research needs for individual chemicals, a systematic review of such documents to identify research themes that could be applied to the multitude of chemicals for which there is little information has not been done. Even for chemicals for which there are considerable data, the information is not sufficient to make an estimate of the chemical's contribution to the burden of disease. The WHO Environmental Health Criteria (EHC) documents and Concise International Chemical Assessment Documents (CICADs) identify research needs or data gaps in our knowledge of ...

*  WHO | Projections of mortality and burden of disease, 2002-2030

Revised global and regional projections of mortality and burden of disease by cause for 2005, 2015 and 2030 are provided below. The GBD estimates of mortality and burden of disease for 2002 are used as a starting point for these projections. The revisions are documented in a working paper, together with references to published papers on data sources and methods. Detailed results for projected deaths and Disability-Adjusted Life Years (DALYs) can be downloaded as Excel spreadsheets. ...

Disease burden: Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity, or other indicators. It is often quantified in terms of quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs), both of which quantify the number of years lost due to disease (YLDs).Incremental cost-effectiveness ratio: The incremental cost-effectiveness ratio (ICER) is a statistic used in cost-effectiveness analysis to summarise the cost-effectiveness of a health care intervention. It is defined by the difference in cost between two possible interventions, divided by the difference in their effect.Vladimir Andreevich Markov: Vladimir Andreevich Markov (; May 8, 1871 – January 18, 1897) was a Russian mathematician, known for proving the Markov brothers' inequality with his older brother Andrey Markov. He died of tuberculosis at the age of 25.Penalized present value: The Penalized Present Value (PPV) is a method of Capital Budgeting under risk developed by Fernando Gómez-Bezares in the 1980s.Value of control: The value of control is a quantitative measure of the value of controlling the outcome of an uncertainty variable. Decision analysis provides a means for calculating the value of both perfect and imperfect control.Recursive partitioning: Recursive partitioning is a statistical method for multivariable analysis. Recursive partitioning creates a decision tree that strives to correctly classify members of the population by splitting it into sub-populations based on several dichotomous independent variables. The process is termed recursive because each sub-population may in turn be split an indefinite number of times until the splitting process terminates after a particular stopping criterion is reached.List of U.S. states by life expectancy: This article presents a list of United States states sorted by their life expectancy at birth and by race/ethnicity in every state where the population of that racial or ethnic group is sufficiently large for robust estimates. The data is taken from the Measure of America's third national human development report, The Measure of America 2013–2014 width="25%" align="center" |Time-trade-off: Time-Trade-Off (TTO) is a tool used in health economics to help determine the quality of life of a patient or group. The individual will be presented with a set of directions such as:Precautionary savings: Precautionary saving is saving (non-expenditure of a portion of income) that occurs in response to uncertainty regarding future income. The precautionary motive to delay consumption and save in the current period rises due to the lack of completeness of insurance markets.Pavement life-cycle cost analysis: In September 1998, the United States Department of Transportation (DoT) introduced risk analysis, a probabilistic approach to account for the uncertainty of the inputs of the cost/benefit evaluation of pavement projects, into its decision-making policies. The traditional (deterministic) approach did not consider the variability of inputs.Monte Carlo methods for option pricing: In mathematical finance, a Monte Carlo option model uses Monte Carlo methods Although the term 'Monte Carlo method' was coined by Stanislaw Ulam in the 1940s, some trace such methods to the 18th century French naturalist Buffon, and a question he asked about the results of dropping a needle randomly on a striped floor or table. See Buffon's needle.Assay sensitivity: Assay sensitivity is a property of a clinical trial defined as the ability of a trial to distinguish an effective treatment from a less effective or ineffective intervention. Without assay sensitivity, a trial is not internally valid and is not capable of comparing the efficacy of two interventions.Cancer screeningResource leak: In computer science, a resource leak is a particular type of resource consumption by a computer program where the program does not release resources it has acquired. This condition is normally the result of a bug in a program.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,National Cancer Research Institute: The National Cancer Research Institute (NCRI) is a UK-wide partnership between cancer research funders, which promotes collaboration in cancer research. Its member organizations work together to maximize the value and benefit of cancer research for the benefit of patients and the public.Inverse probability weighting: Inverse probability weighting is a statistical technique for calculating statistics standardized to a population different from that in which the data was collected. Study designs with a disparate sampling population and population of target inference (target population) are common in application.Von Neumann regular ring: In mathematics, a von Neumann regular ring is a ring R such that for every a in R there exists an x in R such that . To avoid the possible confusion with the regular rings and regular local rings of commutative algebra (which are unrelated notions), von Neumann regular rings are also called absolutely flat rings, because these rings are characterized by the fact that every left module is flat.AIP Conference Proceedings: AIP Conference Proceedings is a serial published by the American Institute of Physics since 1970. It publishes the proceedings from various conferences of physics societies.Self-rated health: Self-rated health (also called Self-reported health, Self-assessed health, or perceived health) refers to both a single question such as “in general, would you say that you health is excellent, very good, good, fair, or poor?” and a survey questionnaire in which participants assess different dimensions of their own health.Interval boundary element method: Interval boundary element method is classical boundary element method with the interval parameters.
List of kanji by stroke count: This Kanji index method groups together the kanji that are written with the same number of strokes. Currently, there are 2,186 individual kanji listed.Temporal analysis of products: Temporal Analysis of Products (TAP), (TAP-2), (TAP-3) is an experimental technique for studyingClosed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Netherlands national rollball team: Vishwaraj JadejaAge adjustment: In epidemiology and demography, age adjustment, also called age standardization, is a technique used to allow populations to be compared when the age profiles of the populations are quite different.Tumor progression: Tumor progression is the third and last phase in tumor development. This phase is characterised by increased growth speed and invasiveness of the tumor cells.Management of HIV/AIDS: The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs in an attempt to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle.Global Risks Report: The Global Risks Report is an annual study published by the World Economic Forum ahead of the Forum’s Annual Meeting in Davos, Switzerland. Based on the work of the Global Risk Network, the report describes changes occurring in the global risks landscape from year to year and identifies the global risks that could play a critical role in the upcoming year.Cancer survival rates: Cancer survival rates vary by the type of cancer, stage at diagnosis, treatment given and many other factors, including country. In general survival rates are improving, although more so for some cancers than others.QRISK: QRISK2 (the most recent version of QRISK) is a prediction algorithm for cardiovascular disease (CVD) that uses traditional risk factors (age, systolic blood pressure, smoking status and ratio of total serum cholesterol to high-density lipoprotein cholesterol) together with body mass index, ethnicity, measures of deprivation, family history, chronic kidney disease, rheumatoid arthritis, atrial fibrillation, diabetes mellitus, and antihypertensive treatment.

(1/1559) Breastfeeding promotion and priority setting in health.

An increase in exclusive breastfeeding prevalence can substantially reduce mortality and morbidity among infants. In this paper, estimates of the costs and impacts of three breastfeeding promotion programmes, implemented through maternity services in Brazil, Honduras and Mexico, are used to develop cost-effectiveness measures and these are compared with other health interventions. The results show that breastfeeding promotion can be one of the most cost-effective health interventions for preventing cases of diarrhoea, preventing deaths from diarrhoea, and gaining disability-adjusted life years (DALYs). The benefits are substantial over a broad range of programme types. Programmes starting with the removal of formula and medications during delivery are likely to derive a high level of impact per unit of net incremental cost. Cost-effectiveness is lower (but still attractive relative to other interventions) if hospitals already have rooming-in and no bottle-feeds; and the cost-effectiveness improves as programmes become well-established. At an annual cost of about 30 to 40 US cents per birth, programmes starting with formula feeding in nurseries and maternity wards can reduce diarrhoea cases for approximately $0.65 to $1.10 per case prevented, diarrhoea deaths for $100 to $200 per death averted, and reduce the burden of disease for approximately $2 to $4 per DALY. Maternity services that have already eliminated formula can, by investing from $2 to $3 per birth, prevent diarrhoea cases and deaths for $3.50 to $6.75 per case, and $550 to $800 per death respectively, with DALYs gained at $12 to $19 each.  (+info)

(2/1559) Opening the debate on DALYs (disability-adjusted life years).

The 1993 World Development Report is proving to be an influential document for the development of the health sector policies in developing countries. One important aspect of the Report concerns its proposals for Disability Adjusted Life Years as a measure of health change and hence effectiveness of interventions. This article comments on the use of such measures in the health policy arena.  (+info)

(3/1559) A critical review of priority setting in the health sector: the methodology of the 1993 World Development Report.

The 1993 World Development Report, Investing in Health, suggests policies to assist governments of developing countries in improving the health of their populations. A new methodology to improve government spending is introduced. Epidemiological and economic analyses from the basis for a global priority setting exercise, leading to a recommended essential public health and clinical services package for low- and middle-income countries. Ministries of Health in many countries have expressed an interest in designing a national package of essential health services, using the methodology. Given the apparent importance attached to the study and its far reaching potential consequences, this article provides an overview of the method, the main issues and problems in estimating the burden of disease as well as the cost-effectiveness of interventions. Strengths and weaknesses in the databases, value judgements and assumptions are identified, leading to a critical analysis of the validity of the priority setting exercise on the global level.  (+info)

(4/1559) Antiviral therapy for neonatal herpes simplex virus: a cost-effectiveness analysis.

Each year, about 1,600 infants in the United States are infected with neonatal herpes simplex virus. We conducted a cost-effectiveness analysis of antiviral drug therapy (acyclovir) for three forms of herpes simplex virus infection: skin, ear, and mouth (SEM), central nervous system (CNS), and disseminated multiorgan (DIS) disease. Five levels of patient outcomes were examined (normal, mild, moderate, severe, dead). We obtained information on disease occurrence and survival from clinical trials and historical reviews of untreated newborns. We considered approaches for treating all or any of the forms of the disease and compared them with no use of antiviral drugs. The main measure of effectiveness was lives saved, including those of descendants of survivors. Costs were measured from a societal perspective and included direct medical costs, institutional care, and special education. We used a discount rate of 3% and valued dollars at 1995 levels. We also considered the perspective of a managed care organization. From a societal viewpoint relative to no treatment, antiviral therapy for SEM resulted in a gain of 0.8 lives and a cost reduction of $78,601 per case. For the treatment of CNS and DIS disease, antiviral therapy saved more lives but at increased cost, with respective marginal costs per additional life saved of $75,125 and $46,619. From a managed care perspective, antiviral therapy is more cost-effective than from a societal viewpoint because costs of institutional care and special education are not the responsibility of managed care organizations. Development of at-home therapies will further improve the cost-effectiveness of antiviral therapy for neonatal herpes simplex virus infection.  (+info)

(5/1559) A cost-effectiveness clinical decision analysis model for schizophrenia.

A model was developed to estimate the medical costs and effectiveness outcomes of three antipsychotic treatments (olanzapine, haloperidol, and risperidone) for patients with schizophrenia. A decision analytic Markov model was used to determine the cost-effectiveness of treatments and outcomes that patients treated for schizophrenia may experience over a 5-year period. Model parameter estimates were based on clinical trial data, published medical literature, and, when needed, clinician judgment. Direct medical costs were incorporated into the model, and outcomes were expressed by using three effectiveness indicators: the Brief Psychiatric Rating Scale, quality-adjusted life years, and lack of relapse. Over a 5-year period, patients on olanzapine had an additional 6.8 months in a disability-free health state based on Brief Psychiatric Rating Scale scores and more than 2 additional months in a disability-free health state based on quality-adjusted life years, and they experienced 13% fewer relapses compared with patients on haloperidol. The estimated 5-year medical cost associated with olanzapine therapy was $1,539 less than that for haloperidol therapy. Compared with risperidone therapy, olanzapine therapy cost $1,875 less over a 5-year period. Patients on olanzapine had approximately 1.6 weeks more time in a disability-free health state (based on Brief Psychiatric Rating Scale scores) and 2% fewer relapses compared with patients on risperidone. Sensitivity analyses indicated the model was sensitive to changes in drug costs and shortened hospital stay. Compared with both haloperidol and risperidone therapy, olanzapine therapy was less expensive and provided superior effectiveness outcomes even with conservative values for key parameters such as relapse and discontinuation rates.  (+info)

(6/1559) Economic benefits of aggressive lipid lowering: a managed care perspective.

Coronary heart disease (CHD) has high prevalence in the United States and is associated with significant mortality as well as costs to society. Hyperlipidemia is a major and common modifiable risk factor for CHD. In clinical trials, cholesterol-lowering strategies have a dramatic impact on CHD risk, cardiovascular events, and mortality. Cost-effectiveness data have established that clinical and economic benefits are gained by instituting early and aggressive lipid-lowering therapy. We present new evidence for the clinical benefits and cost effectiveness of aggressive lipid-lowering therapy as primary or secondary prevention of CHD and describe strategies that managed care organizations can take to benefit from a lipid management program.  (+info)

(7/1559) Willingness to pay in the context of an economic evaluation of healthcare programs: theory and practice.

Cost-benefit analysis (CBA) is defined in the methodology literature as a form of economic evaluation in which both costs and consequences are measured in monetary terms. In recent years we have witnessed renewed enthusiasm for CBA and the use of willingness to pay (WTP) as a method of measuring benefits from healthcare providers. Using the economics perspective, this paper assesses the usefulness of the WTP measure in a context of CBA analysis for economic evaluation of healthcare interventions. Starting from the welfarist approach as the foundation of the analysis, this paper evaluates the benefit and cost of using WTP as a measure of outcome compared mainly with the most commonly used measure of outcome (i.e., quality-adjusted life years) as well as a newly suggested measure of outcome (i.e., healthy-years equivalents). This paper studies this issue from both theoretical and practical aspects. The analysis starts with the premise that we want to use the discipline of economics as the mode of thinking and evaluate the methods suggested using economic criteria. A framework that includes five indicators (or criteria) to help identify the measures of outcome that are proper for use in the context of an economic evaluation are described. Following this framework, the paper argues that from a theoretic perspective the WTP approach is the best available measure, despite its limitations. This paper also describes a new instrument that can be used to measure individuals' WTP as well as a recent experience assessing the feasibility of using such an instrument in the context of evaluating a new pharmaceutical agent in a managed care setting. The conclusion of this study is that this technique holds promise as a method that can generate monetary values for program benefits for future use in CBA.  (+info)

(8/1559) Preferences for health outcomes and cost-utility analysis.

Economic evaluation of health programs consists of the comparative analysis of alternative courses of action in terms of both costs and consequences. The five analytic techniques are cost-consequence analysis, cost-minimization analysis, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. Although all techniques have the same objective of informing decision making in the health programs, they come from different theoretic backgrounds and relate differently to the discipline of economics. Cost-utility analysis formally incorporates the measured preferences of individuals for the health outcome consequences of the alternative programs. The individuals may be actual patients who are experiencing or have experienced the outcomes, or they may be a representative sample of the community, many of whom may someday face the outcomes. The health outcomes, at the most general level, consist of changes in the quantity and quality of life; that is, changes in mortality and morbidity. Changes in quantity of life are measured with mortality; changes in quality of life are measured with health-related quality-of-life instruments. Utilities represent a particular approach to the measurement of health-related quality of life that is founded on a well specified theory and provides an interval scale metric. Changes in quantity of life, as measured in years, can be combined with changes in quality of life, as measured in utilities, to determine the number of quality-adjusted life years gained by a particular health program. This can be compared with the incremental cost of the program to determine the cost per quality-adjusted life-year gained. Utilities may be measured directly on patients or other respondents by means of techniques such as visual analog scaling, standard gamble, or time trade-off. Utilities may be determined indirectly by means of a preference-weighted multi-attribute health status classification system such as the health utilities index. The health utilities index is actually a complete system for use in studies. It consists of questionnaires in various formats and languages, scoring manuals, and descriptive health status classification systems. The health utilities index is useful in clinical studies and in population health surveys, as well as in cost-utility analyses.  (+info)


  • Instead GWWC uses the metric of "quality adjusted life years" (QALYs). (oxfordstudent.com)
  • This paper assesses the appropriateness of QALYs (quality adjusted life years) as a foundation for an index of societal health, and the feasibility of using such an index to guide health care policy. (ehesp.fr)


  • OUTCOME MEASURES: Quality-adjusted life expectancy, costs, and incremental cost-effectiveness ratios. (bepress.com)
  • Compared with current prescription drug coverage, full coverage for post-myocardial infarction secondary prevention therapies would result in greater functional life expectancy (0.35 quality-adjusted life-year) and less resource use ($2500). (ahajournals.org)
  • Respondents traded life expectancy for improved health states and evaluated the health states of well-controlled diabetes and diabetes with non-severe/severe and daytime/nocturnal hypoglycaemic events. (pubmedcentralcanada.ca)
  • A QALY-based index, constructed using the best available data, indicates morbidity has a significant effect on Canadian health status (e.g. life expectancy figures alone overstate community health by about 10%), that the impact of morbidity is unequal across regions and gender, and that role (the ability to fulfil social functions) and mobility dysfunction are important determinants of ill-health in this population. (ehesp.fr)


  • RESULTS OF BASE-CASE ANALYSIS: Compared with empirical short-course therapy, the TEE strategy cost $4938 per quality-adjusted life-year (QALY) gained. (bepress.com)
  • Four existing economic evaluations were found, all of which calculated a very high cost per quality-adjusted life-year (QALY). (nih.gov)


  • Hypoglycaemic events, particularly nocturnal, affect health-related quality of life (HRQoL) via acute symptoms, altered behaviour and fear of future events. (pubmedcentralcanada.ca)
  • Nonetheless, studies based on the Short Form 36 (SF-36) indicate that patients treated with ERT continue to have reduced health-related quality of life (HRQoL) compared with the general population. (nih.gov)



  • No study attached utility values to quality of life measures for ERT-treated patients. (nih.gov)


  • 4 For example, only 46% of patients with CHD report consistent β-blocker use within 1 year of an acute MI, 5 and only 50% of patients are adherent to their prescribed statin. (ahajournals.org)


  • Conclusions- Our analysis suggests that providing full coverage for combination therapy to post-myocardial infarction Medicare beneficiaries would save both lives and money from the societal perspective. (ahajournals.org)


  • From the perspective of Medicare, full drug coverage was highly cost-effective ($7182/quality-adjusted life-year) but not cost saving. (ahajournals.org)


  • Lifetime Costs and Quality-Adjusted Life Years Saved From HI. (lww.com)
  • For the past 50 years or so health care costs have kept rising to the place it is now. (wsj.com)
  • In the model, post-myocardial infarction Medicare beneficiaries who received usual prescription drug coverage under the Part D program lived an average of 8.21 quality-adjusted life-years after their initial event, incurring coronary heart disease-related medical costs of $114 000. (ahajournals.org)
  • Those who received prescription drug coverage without deductibles or copayments lived an average of 8.56 quality-adjusted life-years and incurred $111 600 in coronary heart disease-related costs. (ahajournals.org)



  • In 1996, children living in populations with the highest rates of disease were targeted for immunization, and in 1999 the program was expanded to immunization of children 2 years and older living in states and counties with rates of hepatitis A that historically have been higher than the national average. (aappublications.org)
  • According to the GWWC "pledge calculator", a 10% annual donation by someone who is currently 20 years old, expects to retire at the age of 65, and will earn £31,000 per year on average for the rest of their career, could provide 3,982 years of healthy life and 73,005 years of school attendance for those in the most need. (oxfordstudent.com)


  • I have insurance and my wife and I have to pay $13,000.00 a year before we get any benefits from the policy. (wsj.com)


  • The current level of pledges can save four million years of healthy life, according to Dr Ord. (oxfordstudent.com)


  • When I found out just how much I could help people in developing countries with my money compared to what it could buy for myself (50,000 years of life versus a larger house etc)," said Ord, "I decided I would make a pledge to donate a large part of my income for the rest of my career. (oxfordstudent.com)


  • 60 years who have no contraindications, including persons who report a previous episode of zoster or who have chronic medical conditions. (cdc.gov)