Aggregate Distributional Cost-Effectiveness Analysis of Health Technologies

May 1, 2019, 00:00
10.1016/j.jval.2019.03.006
https://www.valueinhealthjournal.com/article/S1098-3015(19)30152-4/fulltext
Title : Aggregate Distributional Cost-Effectiveness Analysis of Health Technologies
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(19)30152-4&doi=10.1016/j.jval.2019.03.006
First page : 518
Section Title : NOTIONS OF "VALUE" IN HEALTHCARE
Open access? : Yes
Section Order : 518

Background

Health inequalities can be partially addressed through the range of treatments funded by health systems. Nevertheless, although health technology assessment agencies assess the overall balance of health benefits and costs, no quantitative assessment of health inequality impact is consistently undertaken.

Objectives

To assess the inequality impact of technologies recommended under the NICE single technology appraisal process from 2012 to 2014 using an aggregate distributional cost-effectiveness framework.

Methods

Data on health benefits, costs, and patient populations were extracted from the NICE website. Benefits for each technology were distributed to social groups using the observed socioeconomic distribution of hospital utilization for the targeted disease. Inequality measures and estimates of cost-effectiveness were compared using the health inequality impact plane and combined using social welfare indices.

Results

Twenty-seven interventions were evaluated. Fourteen interventions were estimated to increase population health and reduce health inequality, 8 to reduce population health and increase health inequality, and 5 to increase health and increase health inequality. Among the latter 5, social welfare analysis, using inequality aversion parameters reflecting high concern for inequality, indicated that the health gain outweighs the negative health inequality impact.

Conclusions

The methods proposed offer a way of estimating the health inequality impacts of new health technologies. The methods do not allow for differences in technology-specific utilization and health benefits, but require less resources and data than conducting full distributional cost-effectiveness analysis. They can provide useful quantitative information to help policy makers consider how far new technologies are likely to reduce or increase health inequalities.

Categories :
  • Cost/Cost of Illness/Resource Use Studies
  • Decision & Deliberative Processes
  • Electronic Medical & Health Records
  • Health Disparities & Equity
Tags :
  • distributional cost-effectiveness analysis
  • economic evaluation
  • health equity
  • health inequality
  • health technology assessment
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