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Key
Features: |
|
| Title and year of the Document | Prescription for Pharmacoeconomic Analysis - Methods for Cost-utility Analysis (May 2007) |
| Affiliation of authors | PHARMAC, the Pharmaceutical Management Agency |
| Main policy objective | The objective is to secure the best possible health outcomes from within the funding provided. |
| Standard reporting format included | Yes |
| Disclosure | Clear from the Government agency authoring the Guidelines |
| Target audience of funding/ author’s interests | PHARMAC staff, pharmaceutical companies and contracted health
economists preparing economic analyses for PHARMAC |
| Perspective | The health budget and patient, with respect to PHARMAC’s decision criteria. Costs to other Government budgets such as social welfare are excluded because they are outside PHARMAC's budget, but these may be discussed qualitatively in full evaluations. |
| Indication | Not required |
| Target population | The New Zealand population most likely to receive treatment. |
| Subgroup analysis | Yes |
| Choice of comparator | Should be the treatment that most prescribers would replace in New Zealand clinical practice, and the treatment prescribed to the largest number of patients (if this differs from the treatment most prescribers would replace). |
| Time horizon | Should be extended far enough into the future to capture all the major clinical and economic outcomes of the alternatives under assessment. |
| Assumptions required | Yes |
| Preferred analytical technique | Cost-Utility Analysis (CUA) |
| Costs to be included | The range of costs included in cost-utility analyses depends on the level of analysis undertaken, with a wider range of costs included in more detailed analyses. |
| Source of costs | A variety of sources including PHARMAC, the New Zealand Health Information Service (NZHIS), Ministry of Health, and DHBs. |
| Modeling | Yes. Models should avoid unnecessary complexity and should be transparent, well described and reproducible. |
| Systematic review of evidences | Yes. All appropriate levels of evidence should be identified; however well-conducted randomised controlled trials (RCTs) and meta-analyses are the preferred data sources when estimating relative treatment effects. |
| Preference for effectiveness over efficacy | Yes. RCT in combination with real-life data to capture patients with poor compliance. Actual QALYs = potential QALYs x patient continuation/ adherence rate |
| Preferred outcome measure | The overall incremental cost per QALY result should be reported as a point estimate as well as the range over which the cost per QALY is likely to vary. |
| Preferred method to derive utility | Based on EuroQoL with New Zealand tariffs; type 2 (excluding logically inconsistent reponses) in the base case and and type 1 (larger sample size but with logical inconsistencies) in sensitivity analysis |
| Equity issues stated | Yes |
| Discounting costs | 3.5% , and 0%, 5%, and 10% in sensitivity analyses. |
| Discounting outcomes | 3.5% , and 0%, 5%, and 10% in sensitivity analyses. |
| Sensitivity analysis-parameters and range | Parameters to consider include those with the greatest level of uncertainty (e.g. those derived from opinion), and those with the greatest influence on model outcomes (e.g. key clinical variables and costs). |
| Sensitivity analysis-methods | Sensitivity analysis should include univariate (simple), multivariate and extremes (scenario) analysis. The level of sensitivity analysis undertaken should be determined by the level of analysis |
| Presenting results | When presenting the results of the analysis, the overall incremental cost per QALY result should be reported as a point estimate as well as the range over which the cost per QALY is likely to vary. |
| Incremental analysis | Yes |
| Total C/E | No |
| Portability of results (Generalizability) | Yes, New Zealand context |
| Financial impact analysis | Not indicated |
| Mandatory or recommended or voluntary | Recommended |
