Cost-benefit analysis of vaccination: a comparative analysis of eight approaches for valuing changes to mortality and morbidity risks Full Text

Some types of analysis only examine the costs of an intervention or a disease (e.g., cost of illness studies) independently, whereas other types of analysis evaluate both the costs and consequences of an intervention. It is vital to understand the different roles of partial and full economic evaluations. For the hearing aids, corrective lenses and avoiding nursing homes interventions, the reduction in dementia symptoms generated QALYs which was priced by using the VSL, which is a WTP measure.

This possibility presents a dilemma, since there may be situations where the less effective and less expensive treatment is actually more cost-effective. Depending on resource availability, the less costly therapy may represent the best clinical option. The fourth possibility occurs when the new therapy is both more effective and more expensive .

Cost-Benefit Analyses: Advantages

It should also be noted that adding productivity costs to monetised QALYs may lead to double counting, as there remains uncertainty about whether productivity loss has been fully captured in QALY measures . The term CBA is often informally used to refer to any analysis used in decision-making that compares the expected costs and benefits of an investment. In principle, to be regarded as complete, a CBA should capture all benefits due to an intervention, valuing them either at their market value or at the level of consumption that individuals are willing to forego to obtain them. Hence, it has its conceptual roots in welfare economics, which quantifies social welfare in terms of individuals’ willingness-to-pay to increase welfare. By using a consistent, directly comparable metric to value all outcomes, CBA allows comparison with non-health interventions.

What is not so obvious is that an intervention’s chances of being approved is very much dependent on what other interventions are not being evaluated. Not appearing in Table 2 are the education and Medicare interventions, because QALY information was not available for these two interventions. Without consideration of these two interventions, Table 2 reveals that avoiding nursing homes what is a cost benefit analysis would now be approved if the budget were USD 70,000 while before it was rejected. Even with CEA in the form of a CUA, assigning a budget in advance of knowing which interventions will be evaluated, and actually funded, is not a rational economic evaluation method. Three of the new interventions listed in Table 1 had CBAs that used data that can be expressed in units of QALYs.

Data availability statement

As result of that evidence, some middle income countries are encouraged to implement the prevention for a high proportion of pregnant women living with HIV/AIDS. Some cost-benefits estimations were done and clearly demonstrated that it is a potential highly cost-effective method, so the scientific and public health community is very enthusiastic, as well as international agencies. Anirban Basu, PhD is a professor of health economics and the Stergachis Family Endowed Director of the Comparative Health Outcomes, Policy, and Economics Institute at the University of Washington in Seattle. His research focuses on understanding the economic value of health care through applied economic theory, comparative and cost-effectiveness analyses, causal inference methods, program evaluation, and outcomes research. In the United States, a step forward would be the establishment of a national HTA agency that formally incorporates cost-effectiveness evidence along with other contextual elements, such as distributional concerns and budget impact.

Consequently, the importance of reporting other metrics/outcomes as well as DALYs/QALYs is becoming recognised . By foregoing this step, the analysis draws attention exclusively to health benefits and avoids the corresponding ethical and equity issues that can arise when monetizing them . However, it could be argued that some of these ethical and equity issues still arise when setting the cost-effectiveness threshold. For the education and Medicare eligibility interventions, it was the external benefits that were estimated.

Prevalence and risk factors of drug-related problems identified in pharmacy-based medication reviews

Queensland Treasury reports that the discount rate should be project-specific and needs to be determined in consultation between Treasury and the specific agency . The PBAC, an Australian federal government agency , recommends a lower discount rate than the OBPR , also an Australian federal government agency. Several other countries also have higher discount rates recommended by their treasury and central departments and lower values recommended for health evaluations .