NCPA - National Center for Policy Analysis

Website Offers List Of Cost Utility Ratios In Health

January 8, 2001

Understanding whether a given treatment, medical procedure or public health program is cost-effective is an important part of health policy decision-making. Ranking the cost-effectiveness of various health and medical interventions can facilitate the allocation of resources to the most cost-effective ones.

Cost-utility analysis is a type of cost-effectiveness analysis in which health gains are measured in quality-adjusted life years (QALYs). Cost-effectiveness is then a comparative measure of the cost of achieving a gain of one QALY. Cost-utility studies are advantageous for several reasons:

  • They capture in a single health measure gains from both prolongation of life and improved quality of life.
  • They incorporate the values that people place on different health outcomes.
  • They provide a convenient means of comparing analyses of diverse interventions and conditions, across large and small target groups.

The authors identified 228 cost-utility analyses estimating the cost-effectiveness of 647 health-care interventions. The only instances in which interventions actually save money involve very specific groups of people at high risk for certain diseases. However, interventions may still be cost-effective due to relatively low cost per QALY.

  • The drug Warfarin vs. Aspirin is cost-saving in 65-year olds with high-risk of stroke; but Warfarin (vs. Aspirin) in 65-year olds with low-risk for stroke costs $410,000 per QALY gained.
  • Even HIV antibody testing for blood donations costs $400 per QALY gained.

The authors found immunizations are relatively inexpensive. Hypertension treatment (vs. no treatment) is also quite economical, at a cost per QALY gained ranging from $10 to $140. This was especially true for the elderly where it often saves money. Yet, some public heart screenings are especially expensive. For instance, examination and culture for herpes virus vs. examination only in pregnant women at high risk for genital herpes costs $52,000,000 per QALY.

Source: Peter J. Neumann and Richard H. Chapman, "Web Site Offers Comprehensive List of Cost-Utility Ratios in Health and Medicine," Risk In Perspective, Nov. 2000, Harvard Center for Risk Analysis, 718 Huntington Avenue, Boston, Mass. 02115, (617) 432-4497.

 

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