Understanding whether a given treatment, medical procedure or public health programme 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:
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 authors found immunisations 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.
For text http://www.hcra.harvard.edu/nov2000.html
For Cost-Utility Analysis Database
http://www.hsph.harvard.edu/organizations/hcra/cuadatabase/intro.html
For more on Health Care Economics http://www.ncpa.org/pi/health/hedex7.html
