Cost-effectiveness analysis should be mandatory in clinical-effectiveness research

Vijayaraghavan, Bharath Kumar Tirupakuzhi; Willaert, Xavier; Cuthbertson, Brian H.

doi:10.1503/cmaj.73298

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…A similar policy in Bantam (age 13–14) hockey also reduced injury rates by 56% [ 17 ]; however, the effect on costs has not been studied. There has been a call for embracing the value of cost-effectiveness evidence in decision making and even making the use of cost-effectiveness analysis mandatory in clinical effectiveness research [ 18 , 19 ]. Evidence is needed on the associated costs to families and the healthcare system as a result of different rates of injuries from body checking to provide evidence and inform decisions on body checking polices.…”

Section: Introductionmentioning

confidence: 99%

Reality Check 2: The Cost-Effectiveness of Policy Disallowing Body Checking in Non-Elite 13- to 14-Year-Old Ice Hockey Players

Currie

Lee

Palacios-Derflingher

et al. 2021

IJERPH

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Sport-related injuries are the leading cause of injury in youth and are costly to the healthcare system. When body checking is disallowed in non-elite levels of Bantam (ages 13–14 years) ice hockey, the injury rate is reduced, but the impact on costs is unknown. This study compared rates of game injuries and costs among non-elite Bantam ice hockey leagues that disallow body checking to those that did not. Methods: An economic evaluation was conducted alongside a prospective cohort study comparing 608 players from leagues where body checking was allowed in games (Calgary/Edmonton 2014–2015, Edmonton 2015–2016) with 396 players from leagues where it was not allowed in games (Vancouver, Kelowna 2014–2015, Calgary in 2015–2016). The effectiveness measure was rate of game injuries per 1000 player-hours. Costs were estimated based on associated healthcare use within the publicly funded healthcare system as well as privately paid healthcare costs. Probabilistic sensitivity analysis was conducted using bootstrapping. Results: Disallowing body checking reduced the rate of injuries by 4.32 per 1000 player-hours (95% CI −6.92, −1.56) and reduced public and total healthcare system costs by $1556 (95% CI −$2478, −$559) and $1577 (95% CI −$2629, −$500) per 1000 player-hours, respectively. These finding were robust in over 99% of iterations in sensitivity analyses in the public healthcare and the total healthcare system perspectives. There was no statistically significant difference in privately paid healthcare costs (−$65 per 1000 player-hours (95% CI −$220, $99)). Interpretation: Disallowing body checking in non-elite 13–14-year-old ice hockey nationally would prevent injuries and reduce public healthcare costs.

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Section: Introductionmentioning

confidence: 99%

Reality Check 2: The Cost-Effectiveness of Policy Disallowing Body Checking in Non-Elite 13- to 14-Year-Old Ice Hockey Players

Currie

Lee

Palacios-Derflingher

et al. 2021

IJERPH

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“…Analyses of the cost-effectiveness and clinical effectiveness of using data administrative studies [ 62 ] to understand the causes and consequences associated with being homeless were beyond the scope of this review, however, would be useful to include in future studies. Finally, although only administrative data studies were included in this review, other study designs may also be useful to examine.…”

Section: Discussionmentioning

confidence: 99%

Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review

Mitchell,

Waring,

Ahern

et al. 2023

BMC Public Health

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Background Homelessness is a complex societal and public health challenge. Limited information exists about the population-level health and social care-related predictors and consequences of persons with lived experience of homelessness (PEH). Studies that focus on population subgroups or ad hoc questionnaires to gather data are of relatively limited generalisability to whole-population health surveillance and planning. The aim of this study was to find and synthesise information about the risk factors for, and consequences of, experiencing homelessness in whole-population studies that used routine administrative data. Method We performed a systematic search using EMBASE, MEDLINE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO research databases for English-language studies published from inception until February 2023 that reported analyses of administrative data about homelessness and health and social care-related predictors and consequences. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Of the 1224 articles reviewed, 30 publications met the inclusion criteria. The included studies examined a wide range of topic areas, and the homelessness definitions used in each varied considerably. Studies were categorised into several topic areas: Mortality, morbidity and COVID-19; health care usage and hospital re-admission; care home admission and shelter stay; and other (e.g. employment, crime victimisation). The studies reported that that the physical and mental health of people who experience homelessness was worse than that of the general population. Homeless individuals were more likely to have higher risk of hospitalisation, more likely to use emergency departments, have higher mortality rates and were at greater risk of needing intensive care or of dying from COVID-19 compared with general population. Additionally, homeless individuals were more likely to be incarcerated or unemployed. The effects were strongest for those who experienced being homeless as a child compared to those who experienced being homeless later on in life. Conclusions This is the first systematic review of whole-population observational studies that used administrative data to identify causes and consequences associated with individuals who are experiencing homelessness. While the scientific literature provides evidence on some of the possible risk factors associated with being homeless, research into this research topic has been limited and gaps still remain. There is a need for more standardised best practice approaches to understand better the causes and consequences associated with being homeless.

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“…Upstream strategies to prevent infection and hospitalization (e.g., infection prevention through public health measures, including vaccination) are generally the most effective strategies in improving health outcomes and lowering costs that health systems have at their disposal. [23][24][25][26][27] Accordingly, health policy-makers and clinicians also need to consider expenditures on upstream and downstream resource use and medications from this broader population-based budgetary perspective.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of remdesivir plus usual care versus usual care alone for hospitalized patients with COVID-19: an economic evaluation as part of the Canadian Treatments for COVID-19 (CATCO) randomized clinical trial

Lau¹,

Fowler²,

Pinto³

et al. 2022

cmajo

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Background:The role of remdesivir in the treatment of hospitalized patients with COVID-19 remains ill-defined. We conducted a cost-effectiveness analysis alongside the Canadian Treatments for COVID-19 (CATCO) open-label, randomized clinical trial evaluating remdesivir.Methods: Patients with COVID-19 in Canadian hospitals from Aug. 14, 2020, to Apr. 1, 2021, were randomly assigned to receive remdesivir plus usual care versus usual care alone. Taking a public health care payer's perspective, we collected inhospital outcomes and health care resource utilization alongside estimated unit costs in 2020 Canadian dollars over a time horizon from randomization to hospital discharge or death. Data from 1281 adults admitted to 52 hospitals in 6 Canadian provinces were analyzed.

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Cost-effectiveness analysis should be mandatory in clinical-effectiveness research

Cited by 7 publications

References 7 publications

Reality Check 2: The Cost-Effectiveness of Policy Disallowing Body Checking in Non-Elite 13- to 14-Year-Old Ice Hockey Players

Reality Check 2: The Cost-Effectiveness of Policy Disallowing Body Checking in Non-Elite 13- to 14-Year-Old Ice Hockey Players

Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review

Cost-effectiveness of remdesivir plus usual care versus usual care alone for hospitalized patients with COVID-19: an economic evaluation as part of the Canadian Treatments for COVID-19 (CATCO) randomized clinical trial

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