Cost-Effectiveness Analysis Flashcards
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Read the first 7 Cost-Effectiveness Analysis flashcards as text
A budget impact analysis (BIA) differs from CEA primarily because BIA:
Answer: Focuses on the financial consequences of adopting an intervention for a specific payer over a defined time horizon
BIA estimates how a new treatment affects a payer's budget over 1–5 years, focusing on affordability rather than value per health outcome.
In a decision tree model for CEA, 'terminal nodes' represent:
Answer: Final health outcomes or costs at the end of a pathway
Terminal nodes (leaf nodes) are the endpoints of each pathway in a decision tree, where the associated payoff (cost and outcome) is assigned.
Which method is used to estimate health state utilities when direct preference elicitation data are unavailable?
Answer: Mapping (crosswalk) from clinical outcome scales to utility instruments
Mapping algorithms statistically convert scores from clinical scales (e.g., EORTC, FACT) to utility values when direct elicitation studies are lacking.
The 'societal perspective' in CEA includes which costs that are excluded from the payer perspective?
Answer: Productivity losses, caregiver time, and patient out-of-pocket costs
The societal perspective captures all resources regardless of who bears the cost, including indirect costs like productivity loss and unpaid caregiver time.
A tornado diagram in one-way sensitivity analysis displays parameters:
Answer: Ranked by the magnitude of their impact on the ICER, with the most influential at the top
In a tornado diagram, parameters are sorted so the widest bar (greatest influence on ICER) appears at the top, resembling a tornado shape.
Microsimulation (individual patient simulation) differs from cohort-level Markov models because it:
Answer: Tracks individual patients through health states, allowing history-dependence and heterogeneity
Microsimulation simulates each patient individually, enabling memory-dependent transitions and patient-level variability that cohort models cannot capture.
When should an analyst use a lifetime horizon in a CEA model?
Answer: When the intervention has long-term or permanent effects on mortality or morbidity
A lifetime horizon is appropriate when the intervention produces health effects that persist over many years, ensuring all relevant costs and benefits are captured.