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Estimating the Reference Incremental Cost-Effectiveness Ratio for the Australian Health System.
- Source :
- PharmacoEconomics; Feb2018, Vol. 36 Issue 2, p239-252, 14p
- Publication Year :
- 2018
-
Abstract
- <bold>Background: </bold>Spending on new healthcare technologies increases net population health when the benefits of a new technology are greater than their opportunity costs-the benefits of the best alternative use of the additional resources required to fund a new technology.<bold>Objective: </bold>The objective of this study was to estimate the expected incremental cost per quality-adjusted life-year (QALY) gained of increased government health expenditure as an empirical estimate of the average opportunity costs of decisions to fund new health technologies. The estimated incremental cost-effectiveness ratio (ICER) is proposed as a reference ICER to inform value-based decision making in Australia.<bold>Methods: </bold>Empirical top-down approaches were used to estimate the QALY effects of government health expenditure with respect to reduced mortality and morbidity. Instrumental variable two-stage least-squares regression was used to estimate the elasticity of mortality-related QALY losses to a marginal change in government health expenditure. Regression analysis of longitudinal survey data representative of the general population was used to isolate the effects of increased government health expenditure on morbidity-related, QALY gains. Clinical judgement informed the duration of health-related quality-of-life improvement from the annual increase in government health expenditure.<bold>Results: </bold>The base-case reference ICER was estimated at AUD28,033 per QALY gained. Parametric uncertainty associated with the estimation of mortality- and morbidity-related QALYs generated a 95% confidence interval AUD20,758-37,667.<bold>Conclusion: </bold>Recent public summary documents suggest new technologies with ICERs above AUD40,000 per QALY gained are recommended for public funding. The empirical reference ICER reported in this article suggests more QALYs could be gained if resources were allocated to other forms of health spending. [ABSTRACT FROM AUTHOR]
- Subjects :
- COST effectiveness
HEALTH care reform
MEDICAL care
PUBLIC spending
MANAGEMENT of public spending
TECHNOLOGY & economics
MEDICAL care cost statistics
COMPARATIVE studies
DECISION making
RESEARCH methodology
MEDICAL cooperation
QUALITY assurance
QUALITY of life
REGRESSION analysis
RESEARCH
RESEARCH funding
GOVERNMENT aid
EVALUATION research
QUALITY-adjusted life years
Subjects
Details
- Language :
- English
- ISSN :
- 11707690
- Volume :
- 36
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- PharmacoEconomics
- Publication Type :
- Academic Journal
- Accession number :
- 127931087
- Full Text :
- https://doi.org/10.1007/s40273-017-0585-2