Estimating the costs of non-medical consumption in life-years gained for economic evaluations

Kellerborg, Klas; Wouterse, Bram; Brouwer, Werner; Baal, Pieter van

doi:10.1016/j.socscimed.2021.114414

Cited by 5 publications

(2 citation statements)

References 47 publications

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“…The empirical results in Meltzer's paper suggests future costs could substantially alter cost-effectiveness of common medical interventions, especially if the intervention increases survival more than quality of life [4]. Further, non-medical costs by age have been estimated for the Netherlands by Kellerborg et al (2021) [15] and added to the PAID tool, using individual-level data from a cross-sectional Dutch Household Consumption survey from 2004. Utilizing these data, they estimated non-medical costs for an average household by age.…”

Section: Introductionmentioning

confidence: 99%

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Future medical and non-medical costs and their impact on the cost-effectiveness of life-prolonging interventions: a comparison of five European countries

et al. 2022

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When healthcare interventions prolong life, people consume medical and non-medical goods during the years of life they gain. It has been argued that the costs for medical consumption should be included in cost-effectiveness analyses from both a healthcare and societal perspective, and the costs for non-medical consumption should additionally be included when a societal perspective is applied. Standardized estimates of these so-called future costs are available in only a few countries and the impact of inclusion of these costs is likely to differ between countries. In this paper we present and compare future costs for five European countries and estimate the impact of including these costs on the cost-effectiveness of life-prolonging interventions. As countries differ in the availability of data, we illustrate how both individual- and aggregate-level data sources can be used to construct standardized estimates of future costs. Results show a large variation in costs between countries. The medical costs for the Netherlands, Germany, and the United Kingdom are large compared to Spain and Greece. Non-medical costs are higher in Germany, Spain, and the United Kingdom than in Greece. The impact of including future costs on the ICER similarly varied between countries, ranging from €1000 to €35,000 per QALY gained. The variation between countries in impact on the ICER is largest when considering medical costs and indicate differences in both structure and level of healthcare financing in these countries. Case study analyses were performed in which we highlight the large impact of including future costs on ICER relative to willingness-to-pay thresholds.

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Section: Introductionmentioning

confidence: 99%

“…Unrelated medical costs in the Netherlands produced by Van Baal and colleagues and updated by Kellerborg and colleagues[9,10] 3. Non-medical costs in the Netherlands produced by Kellerborg and colleagues[15] 4. Unrelated medical costs in the United Kingdom produced by Perry-Duxbury and colleagues[11] 5.…”

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confidence: 99%

Future medical and non-medical costs and their impact on the cost-effectiveness of life-prolonging interventions: a comparison of five European countries

et al. 2022

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Distributional consequences of including survivor costs in economic evaluations

et al. 2021

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When medical interventions postpone death, costs arise in added life-years due to consumption of medical and non-medical goods (Meltzer, 1997). Whether or not to include these costs in economic evaluations conducted from a societal perspective remains an issue of controversy (de Vries, van Baal, & Brouwer, 2018). Many national guidelines for economic evaluation currently do not recommend the inclusion of survivor costs (ISPOR, 2018). However, the recently updated, influential US guidelines do specifically recommend their inclusion (Sanders et al., 2016). The few studies that investigated

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The impact of different perspectives on the cost-effectiveness of remote patient monitoring for patients with heart failure in different European countries

Mokri,

van Baal,

Rutten-van Mölken

2024

Eur J Health Econ

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Background and objective Heart failure (HF) is a complex clinical syndrome with high mortality and hospitalization rates. Non-invasive remote patient monitoring (RPM) interventions have the potential to prevent disease worsening. However, the long-term cost-effectiveness of RPM remains unclear. This study aimed to assess the cost-effectiveness of RPM in the Netherlands (NL), the United Kingdom (UK), and Germany (DE) highlighting the differences between cost-effectiveness from a societal and healthcare perspective. Methods We developed a Markov model with a lifetime horizon to assess the cost-effectiveness of RPM compared with usual care. We included HF-related hospitalization and non-hospitalization costs, intervention costs, other medical costs, informal care costs, and costs of non-medical consumption. A probabilistic sensitivity analysis and scenario analyses were performed. Results RPM led to reductions in HF-related hospitalization costs, but total lifetime costs were higher in all three countries compared to usual care. The estimated incremental cost-effectiveness ratios (ICERs), from a societal perspective, were €27,921, €32,263, and €35,258 in NL, UK, and DE respectively. The lower ICER in the Netherlands was mainly explained by lower costs of non-medical consumption and HF-related costs outside of the hospital. ICERs, from a healthcare perspective, were €12,977, €11,432, and €11,546 in NL, the UK, and DE, respectively. The ICER was most sensitive to the effectiveness of RPM and utility values. Conclusions This study demonstrates that RPM for HF can be cost-effective from both healthcare and societal perspective. Including costs of living longer, such as informal care and non-medical consumption during life years gained, increased the ICER.

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Estimating the costs of non-medical consumption in life-years gained for economic evaluations

Cited by 5 publications

References 47 publications

Future medical and non-medical costs and their impact on the cost-effectiveness of life-prolonging interventions: a comparison of five European countries

Future medical and non-medical costs and their impact on the cost-effectiveness of life-prolonging interventions: a comparison of five European countries

Distributional consequences of including survivor costs in economic evaluations

The impact of different perspectives on the cost-effectiveness of remote patient monitoring for patients with heart failure in different European countries

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