THE DEVELOPMENT OF COST-EFFECTIVENESS INDICES WITH EQUITY IMPLICATIONS FOR THE ECONOMIC EVALUATION OF HEALTH CARE
Author(s)
Jung-Der Wang, MD, ScD, Professor1, Fu-Chang Hu, MS, ScD, Biostatistician21National Taiwan University, Taipei, Taiwan; 2 National Taiwan University Hospital, Taipei, Taiwan
The incremental cost-effectiveness ratio (ICER) with number of dollars per quality-adjusted life year (QALY) has been extensively used in cost-effectiveness analysis (CEA) for improving efficiency in health care, but there is a lack of simple CEA indicators to take the equity issue in health into consideration. In this paper, by adjusting the ordinary ICERs with the quality-adjusted life expectancy (QALE) of the age- and gender-matched general population, we developed the CEA indicators based on and/or weighted by relative health gap to improve the distributive justice. If we collect the quality of life and survival data to estimate the QALY gained by a certain intervention for a specific disease, then the CEA indicators based on and/or weighted by relative health gain can also be developed to reduce the unintended inequity. The proposed six new CEA indicators with equity implications were empirically calculated for comparisons among the diseases of end stage renal disease, acquired immune deficiency syndrome, liver cancer, and breast cancer to demonstrate their applicability.
Conference/Value in Health Info
2008-05, ISPOR 2008, Toronto, Ontario, Canada
Value in Health, Vol. 11, No. 3 (May/June 2008)
Code
PMC10
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Multiple Diseases