This study provides an EQ-5D social value set for domestic use in Chile. Our results differ from those reported in other countries, justifying the need to perform local studies that adequately reflect societal health preferences.
The availability of a Hispanic model for EQ-5D valuations represents a significant new option for decision-makers, providing a set of social preference weights for use in Latin American countries that presently lack their own domestic value set.
Background: The measurement of health benefits is a key issue in health economic evaluations. There is very scarce empirical literature exploring the differences of using quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs) as benefit metrics and their potential impact in decision-making.
Methods: Two previously published models delivering outputs in QALYs, were adapted to estimate DALYs: a Markov model for human papilloma virus (HPV) vaccination, and a pneumococcal vaccination deterministic model (PNEUMO). Argentina, Chile, and the United Kingdom studies were used, where local EQ-5D social value weights were available to provide local QALY weights. A primary study with descriptive vignettes was done (n = 73) to obtain EQ-5D data for all health states included in both models. Several scenario analyses were carried-out to evaluate the relative importance of using different metrics (DALYS or QALYs) to estimate health benefits on these economic evaluations.
Results: QALY gains were larger than DALYs avoided in all countries for HPV, leading to more favorable decisions using the former. With discounting and age-weighting – scenario with greatest differences in all countries – incremental DALYs avoided represented the 75%, 68%, and 43% of the QALYs gained in Argentina, Chile, and United Kingdom respectively. Differences using QALYs or DALYs were less consistent and sometimes in the opposite direction for PNEUMO. These differences, similar to other widely used assumptions, could directly influence decision-making using usual gross domestic products (GDPs) per capita per DALY or QALY thresholds.
Conclusion: We did not find evidence that contradicts current practice of many researchers and decision-makers of using QALYs or DALYs interchangeably. Differences attributed to the choice of metric could influence final decisions, but similarly to other frequently used assumptions.
Economic evaluations in healthcare: Basic concepts and classification The growing burden of healthcare costs has created an urgent need to economically appraise health interventions in order to prioritise those which offer better value for money in the local context. The aim of this article is to provide some basic principles of economic evaluations which will improve physicians' understanding of the methodology involved in this type of analysis and will also help to show how their clinical practice relates to the economics of healthcare financing. Some of the main concepts describe is this paper include the definition and classification of economic evaluations in healthcare (i.e. Cost-minimization, cost-effectiveness, cost-utility and cost-benefit) and a brief description of a cost-effectiveness plane.
There are a small number of Latin American countries that report research about dental status with national representation samples. Most of these studies have been conducted as national oral health surveys, and fieldwork was carried out by dentists. The development of oral health research in this part of the world should be promoted as these surveys provide relevant information to monitor oral health and evaluate the effectiveness of health programmes.
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