A comprehensive review of official discount rates in guidelines of health economic evaluations over time: the trends and roots

Khorasani, Elahe; Davari, Majid; Kebriaeezadeh, Abbas; Fatemi, Farshad; Sari, Ali Akbari; Varahrami, Vida

doi:10.1007/s10198-022-01445-x

Cited by 10 publications

(5 citation statements)

References 58 publications

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“…They adopted a different approach to report the present value of future costs and health outcomes in their models, indeed reflecting the uncertainty around the choice of the most appropriate value for discount rates and the lack of consensus among economists on the topic [ 39 ]. Discount rates play a crucial role in economic evaluation studies and can change resource allocation and prioritization of healthcare [ 40 ]. Discount rates, in fact, change the weight of future events (the lower the rates, the higher the weights).…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluations of Magnetic Resonance Image-Guided Radiotherapy (MRIgRT): A Systematic Review

Castelluccia

Mincarone

Tumolo

et al. 2022

IJERPH

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Objectives: This review systematically summarizes the evidence on the economic impact of magnetic resonance image-guided RT (MRIgRT). Methods: We systematically searched INAHTA, MEDLINE, and Scopus up to March 2022 to retrieve health economic studies. Relevant data were extracted on study type, model inputs, modeling methods and economic results. Results: Five studies were included. Two studies performed a full economic assessment to compare the cost-effectiveness of MRIgRT with other forms of image-guided radiation therapy. One study performed a cost minimization analysis and two studies performed an activity-based costing, all comparing MRIgRT with X-ray computed tomography image-guided radiation therapy (CTIgRT). Prostate cancer was the target condition in four studies and hepatocellular carcinoma in one. Considering the studies with a full economic assessment, MR-guided stereotactic body radiation therapy was found to be cost effective with respect to CTIgRT or conventional or moderate hypofractionated RT, even with a low reduction in toxicity. Conversely, a greater reduction in toxicity is required to compete with extreme hypofractionated RT without MR guidance. Conclusions: This review highlights the great potential of MRIgRT but also the need for further evidence, especially for late toxicity, whose reduction is expected to be the real added value of this technology.

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Section: Discussionmentioning

confidence: 99%

Economic Evaluations of Magnetic Resonance Image-Guided Radiotherapy (MRIgRT): A Systematic Review

Castelluccia

Mincarone

Tumolo

et al. 2022

IJERPH

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“…Health utility of states was measured by EQ-5D-5L in Vietnam [11]. The discount rate for effects was also 3% in the base case according to published guidelines [12,13]. Cost discount rate Fixed 3% Guidelines [12,13] Notes: SBP: systolic blood pressure; CVD: cardiovascular disease.…”

Section: Health Utilitiesmentioning

confidence: 99%

“…The discount rate for effects was also 3% in the base case according to published guidelines [12,13]. Cost discount rate Fixed 3% Guidelines [12,13] Notes: SBP: systolic blood pressure; CVD: cardiovascular disease. The data were strati ed by sex to align with the criteria of the risk prediction tool…”

Section: Health Utilitiesmentioning

confidence: 99%

Cost-utility analysis of community-based interventions for hypertension control in Vietnam

Nguyen,

Ha,

Tran

et al. 2024

Preprint

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Between 2010 and 2011, stakeholders implemented a multi-faceted community-based intervention in response to the escalating issue of uncontrolled hypertension in Hung Yen province, Vietnam. This initiative integrated expanded community health worker services, home blood pressure self-monitoring, and a unique "storytelling intervention" into routine clinical care. From the limited societal perspective, our study evaluates the cost-effectiveness of this intervention using a Markov model with a one-year cycle over a lifetime horizon. The analysis, based on a cohort of 671 patients, reveals a lifetime incremental cost of approximately VND 90.37 million (USD 3,930) per quality-adjusted life year (QALY) gained. With a willingness to pay at three times GDP (VND 259.2 million per QALY), the intervention proves cost-effective 80% of the time. This research underscores the potential of the community-based approach to effectively control hypertension, offering valuable insights into its broader implications for public health.

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“…Discounting is an economic method to adjust the values of the costs and benefits occurred in different time periods, reflecting the individual's time preference for current benefits over future benefits (1). It is a near-universal consensus in the guidelines on the economic evaluation for health technology, employing discount rate for cost and effect to convert the future value to the present value is the standard practice (2).…”

Section: Introductionmentioning

confidence: 99%

“…This prevailed discount rate of 3 percent and 5 percent used might largely be influenced the early works done by the leading experts in the field of health economics (7). However, without adjusting the discount rate according to the economic conditions of individual countries, inappropriate discount rate may be used and potentially adversely affect the cost-effectiveness analysis (2).…”

Section: Introductionmentioning

confidence: 99%

A systematic review on the appropriate discounting rates for the economic evaluation of gene therapies: whether a specific approach is justified to tackle the challenges?

Qiu,

Aballéa,

Pochopień

et al. 2024

Int J Technol Assess Health Care

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Objectives Discounting the cost and effect for health intervention is a controversial topic over the last two decades. In particular, the cost-effectiveness of gene therapies is especially sensitive to the discount rate because of the substantial delay between the upfront cost incurred and long-lasing clinical benefits received. This study aims to investigate the influence of employing alternative discount rates on the incremental cost-effectiveness ratio (ICER) of gene therapies. Methods A systematic review was conducted to include health economic evaluations of gene therapies that were published until April 2023. Results Sensitivity or scenario analysis indicated that discount rate represented one of the most influential factors for the ICERs of gene therapies. Discount rate for cost and benefit was positively correlated with the cost-effectiveness of gene therapies, that is, a lower discount rate significantly improves the ICERs. The alternative discount rate employed in some cases could be powerful to alter the conclusion on whether gene therapies are cost-effective and acceptable for reimbursement. Conclusions Although discount rate will have substantial influence on the ICERs of gene therapies, there lacks solid evidence to justify a different discounting rule for gene therapies. However, it is proposed that the discount rate in the reference case should be updated to reflect the real-time preference, which in turn will affect the ICERs and reimbursement of gene therapies more profoundly than conventional therapies.

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A comprehensive review of official discount rates in guidelines of health economic evaluations over time: the trends and roots

Cited by 10 publications

References 58 publications

Economic Evaluations of Magnetic Resonance Image-Guided Radiotherapy (MRIgRT): A Systematic Review

Economic Evaluations of Magnetic Resonance Image-Guided Radiotherapy (MRIgRT): A Systematic Review

Cost-utility analysis of community-based interventions for hypertension control in Vietnam

A systematic review on the appropriate discounting rates for the economic evaluation of gene therapies: whether a specific approach is justified to tackle the challenges?

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