Costt-Effectiveness of Antepartum Prevention of Rh Immunization

Torrance, George W.; Zipursky, Alvin

doi:10.1016/s0095-5108(18)30920-5

Cited by 86 publications

(29 citation statements)

References 26 publications

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“…• 'League table approaches': the threshold created by this method is the cost-effectiveness ratio of the last intervention (from a table of most to least cost effective) to be approved as funds are exhausted [9]. If a new intervention falls below this threshold, then (theoretically) greater benefits could be created by having it replace this marginal intervention in a fixed budget.…”

Section: The History Of Threshold Creation In Lmicsmentioning

confidence: 99%

Are Current Cost-Effectiveness Thresholds for Low- and Middle-Income Countries Useful? Examples from the World of Vaccines

2014

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The World Health Organization's CHOosing Interventions that are Cost Effective (WHO-CHOICE) thresholds for averting a disability-adjusted life-year of one to three times per capita income have been widely cited and used as a measure of cost effectiveness in evaluations of vaccination for low-and middle-income countries (LMICs). These thresholds were based upon criteria set out by the WHO Commission on Macroeconomics and Health, which reflected the potential economic returns of interventions. The CHOICE project sought to evaluate a variety of health interventions at a subregional level and classify them into broad categories to help assist decision makers, but the utility of the thresholds for within-country decision making for individual interventions (given budgetary constraints) has not been adequately explored. To examine whether the 'WHO-CHOICE thresholds' reflect funding decisions, we examined the results of two recent reviews of cost-effectiveness analyses of human papillomavirus and rotavirus vaccination in LMICs, and we assessed whether the results of these studies were reflected in funding decisions for these vaccination programmes. We found that in many cases, programmes that were deemed cost effective were not subsequently implemented in the country. We consider the implications of this finding, the advantages and disadvantages of alternative methods to estimate thresholds, and how cost perspectives and the funders of healthcare may impact on these choices.

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Section: The History Of Threshold Creation In Lmicsmentioning

confidence: 99%

Are Current Cost-Effectiveness Thresholds for Low- and Middle-Income Countries Useful? Examples from the World of Vaccines

2014

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“…Both options are effective 3 9. Antenatal programmes are cost effective if reserved for women in their first pregnancy, as they were in the Derbyshire study 1011…”

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confidence: 99%

Preventing RhD haemolytic disease of the newborn

Dijk¹

1997

BMJ

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“…Using a generic outcome measure, such as QALYs, enables comparisons across different costeffectiveness analyses. League tables have been published both in North America and the United Kingdom [33,34]. An extensive list of over five hundred ICERs for life-saving interventions, including interventions for heart diseases, has also been presented by Tengs [35].…”

Section: Ranking or League Tablesmentioning

confidence: 99%

The matter of economic evaluations in health policy decision-making : The case of the Swedish national guidelines for heart diseases

Eckard¹

2015

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Economic evaluations are used to inform decision makers about the efficient allocation of scarce healthcare resources and are generated with the direct intent to support decisions in healthcare. Producing guidelines is a complex process and the inclusion of health-economic aspects in the formulation of the Swedish national guidelines as a basis for the written recommendations (priority gradings), distinguishes them from their European counterparts. Despite the increased use of cost-effectiveness data in decision-making, little is known about the actual use of such data. This thesis covers issues concerning how economic evaluations matter in health policy decision-making. The thesis includes four papers based on the Swedish national guidelines for heart diseases, one of the most prominent examples in Sweden of following the notion of evidence-based policy (EBP), in order to inform explicit priority setting. Both Papers I and II followed a qualitative case study design, based on the same data set. Paper I explored how a specific working group, the Priority Setting Group (PSG), handled the various forms of evidence and values when producing the national guidelines. Two themes were identified in reaching collective agreement in priority gradings; group facilitation activities and avoiding deadlock in the discussion. The work process involved disagreement and negotiation as part of that task. Paper I contributes to the theoretical and practical debate on EBP. Paper II focused on the use of cost-effectiveness data as decision support in the PSG work process. The paper addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. Three themes were identified. The paper contributes to knowledge on how cost-effectiveness evidence was used in actual decision-making. The use of cost-effectiveness evidence was one of many tools employed to avoid deadlock in discussion and to reach a priority grading, when the overall evidence base was weak, in times of uncertainty and on the introduction of new expensive medical technologies. Quantitative research methods were used for both Papers III and IV. Paper III explored how the PSG was presented with cost-effectiveness evidence as decision support and as a basis for their priority gradings. Cost-effectiveness ratios (ICERs) were provided, based on a systematic literature review, as well as how the results may be conveyed and communicated, for the treatment of heart diseases using a cost-effectiveness ranking or league and providing valid information within a limited space, aiding decision makers on the allocation of healthcare resources. The thesis also includes decision support in the form of cost-effectiveness analysis on catheter ablation treatment. Paper IV provides an example of presenting evidence in the form of a decision-analytic model. The modelling approach provides an analytic framework for decision-making, specifically under conditions of uncertainty as in the introduction of new medical technology. ...

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Costt-Effectiveness of Antepartum Prevention of Rh Immunization

Cited by 86 publications

References 26 publications

Are Current Cost-Effectiveness Thresholds for Low- and Middle-Income Countries Useful? Examples from the World of Vaccines

Are Current Cost-Effectiveness Thresholds for Low- and Middle-Income Countries Useful? Examples from the World of Vaccines

Preventing RhD haemolytic disease of the newborn

The matter of economic evaluations in health policy decision-making : The case of the Swedish national guidelines for heart diseases

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