Cost-Effectiveness Analysis Flashcards
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Read the first 7 Cost-Effectiveness Analysis flashcards as text
In a cost-effectiveness analysis, the incremental cost-effectiveness ratio (ICER) is calculated as:
Answer: Difference in costs divided by difference in health outcomes between two alternatives
The ICER compares the additional cost of one intervention over another relative to the additional health benefit it provides.
Which type of sensitivity analysis tests the impact of simultaneously varying multiple input parameters?
Answer: Probabilistic sensitivity analysis
Probabilistic sensitivity analysis (PSA) assigns distributions to parameters and simultaneously varies them using Monte Carlo simulation.
A healthcare intervention has an ICER of $45,000 per QALY. Using the US threshold of $50,000–$150,000 per QALY, this intervention is considered:
Answer: Cost-effective at the lower bound of the threshold
An ICER of $45,000/QALY falls below $50,000, making it cost-effective even at the most conservative US threshold.
What does a cost-effectiveness acceptability curve (CEAC) display?
Answer: The probability that an intervention is cost-effective across a range of willingness-to-pay thresholds
A CEAC shows, for each WTP threshold, the probability that the intervention is cost-effective based on PSA results.
In a Markov model used for CEA, 'cycle length' refers to:
Answer: The time period after which patients can transition between health states
Cycle length defines the intervals at which transitions between health states occur in a Markov model.
Which perspective in CEA includes only direct medical costs paid by the insurance payer?
Answer: Payer perspective
The payer perspective captures reimbursed medical costs but excludes patient out-of-pocket expenses, productivity losses, and indirect costs.
Half-cycle correction in Markov models is applied to:
Answer: Correct the overestimation of time spent in each state when events occur throughout a cycle
Half-cycle correction assumes events occur on average at the midpoint of each cycle rather than at the start, reducing systematic bias.