ECONOMIC EVALUATION AND THE POSTPONEMENT OF HEALTH CARE COSTS

The inclusion of medical costs in life years gained in economic evaluations of health care technologies has long been controversial. Arguments in favour of the inclusion of such costs are gaining support, which shifts the question from whether to how to include these costs. This paper elaborates on the issue how to include cost in life years gained in cost effectiveness analysis given the current practice of economic evaluations in which costs of related diseases are included. We combine insights from the theoretical literature on the inclusion of unrelated medical costs in life years gained w... Mehr ...

Verfasser: van Baal, Pieter H. M.
Feenstra, Talitha L.
Polder, Johan J.
Hoogenveen, Rudolf T.
Brouwer, Werner B. F.
Dokumenttyp: Artikel
Erscheinungsdatum: 2011
Reihe/Periodikum: van Baal , P H M , Feenstra , T L , Polder , J J , Hoogenveen , R T & Brouwer , W B F 2011 , ' ECONOMIC EVALUATION AND THE POSTPONEMENT OF HEALTH CARE COSTS ' , Health Economics , vol. 20 , no. 4 , pp. 432-445 . https://doi.org/10.1002/hec.1599
Schlagwörter: economic evaluation / medical costs in life years gained / modeling / cost effectiveness analysis / FUTURE COSTS / MEDICAL COSTS / LAST YEAR / LIFE / EXPENDITURE / SMOKING / INTERVENTIONS / PREVENTION / IMPACT / NETHERLANDS
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29192361
Datenquelle: BASE; Originalkatalog
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Link(s) : https://hdl.handle.net/11370/c6733bdd-74ac-493f-a64f-b1a90b9335f0

The inclusion of medical costs in life years gained in economic evaluations of health care technologies has long been controversial. Arguments in favour of the inclusion of such costs are gaining support, which shifts the question from whether to how to include these costs. This paper elaborates on the issue how to include cost in life years gained in cost effectiveness analysis given the current practice of economic evaluations in which costs of related diseases are included. We combine insights from the theoretical literature on the inclusion of unrelated medical costs in life years gained with insights from the so-called 'red herring' literature. It is argued that for most interventions it would be incorrect to simply add all medical costs in life years gained to an ICER, even when these are corrected for postponement of the expensive last year of life. This is the case since some of the postponement mechanism is already captured in the unadjusted ICER by modelling the costs of related diseases. Using the example of smoking cessation, we illustrate the differences and similarities between different approaches. The paper concludes with a discussion about the proper way to account for medical costs in life years gained in economic evaluations. Copyright (C) 2010 John Wiley & Sons, Ltd.