The Use of Quality-Adjusted Life-Years in the Economic Evaluation of Health Technologies in Spain: A Review of the 1990–2009 Literature

Rodrı́guez, José Manuel; Paz, Silvia; Lizán, Luís; González, Paloma

doi:10.1016/j.jval.2010.10.039

Cited by 14 publications

(9 citation statements)

References 30 publications

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“…Costs, utility weights and other key model parameters are shown in Table 1 . Cost-effectiveness was measured as the Incremental Cost-Effectiveness Ratio (ICER) and was assessed based on a Willingness-To-Pay (WTP) threshold of €30,000 per QALY averted which has been previously used in Spain [ 52 – 54 ].…”

Section: Methodsmentioning

confidence: 99%

Economic and epidemiologic impact of guidelines for early ART initiation irrespective of CD4 count in Spain

Kasaie

Radford

Kapoor³

et al. 2018

PLoS ONE

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IntroductionEmerging data suggest that early antiretroviral therapy (ART) could reduce serious AIDS and non-AIDS events and deaths but could also increase costs. In January 2016, the Spanish guidelines were updated to recommend ART at any CD4 count. However, the epidemiologic and economic impacts of early ART initiation in Spain remain unclear.MethodsThe Johns Hopkins HIV Economic-Epidemiologic Mathematical Model (JHEEM) was utilized to estimate costs, transmissions, and outcomes in Spain over 20 years. We compared implementation of guidelines for early ART initiation to a counterfactual scenario deferring ART until CD4-counts fall below 350 cells/mm3. We additionally studied the impact of early ART initiation in combination with improvements to HIV screening, care linkage and engagement.ResultsEarly ART initiation (irrespective of CD4-count) is expected to avert 20,100 [95% Uncertainty Range (UR) 11,100–83,000] new HIV cases over the next two decades compared to delayed ART (28% reduction), at an incremental health system cost of €1.05 billion [€0.66 – €1.63] billion, and an incremental cost-effectiveness ratio (ICER) of €29,700 [€13,700 – €41,200] per QALY gained. Projected ICERs declined further over longer time horizon; e.g., an ICER of €12,691 over 30 years. Furthermore, the impact of early ART initiation was potentiated by improved HIV screening among high-risk individuals, averting an estimated 41,600 [23,200–172,200] HIV infections (a 58% decline) compared to delayed ART.ConclusionsRecommendations for ART initiation irrespective of CD4-counts are cost-effective and could avert > 30% of new cases in Spain. Improving HIV diagnosis can amplify this impact.

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Section: Methodsmentioning

confidence: 99%

Economic and epidemiologic impact of guidelines for early ART initiation irrespective of CD4 count in Spain

Kasaie

Radford

Kapoor³

et al. 2018

PLoS ONE

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“…One thousand cohorts of 1000 patients were simulated in the PSA and used to generate cost-effectiveness scatterplots and acceptability curves which were used to analyze the probability that a treatment may be cost-effective over a range of willingness to pay thresholds. No fixed willingness to pay threshold exists in Spain but earlier studies have used thresholds of between EUR 20,000 and EUR 30,000 per QALY gained [48, 49]. …”

Section: Methodsmentioning

confidence: 99%

Liraglutide Versus Lixisenatide: Long-Term Cost-Effectiveness of GLP-1 Receptor Agonist Therapy for the Treatment of Type 2 Diabetes in Spain

Mezquita-Raya

Arellano²,

Kragh

et al. 2017

Diabetes Ther

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Introduction Glucagon-like peptide-1 (GLP-1) receptor agonists are used successfully in the treatment of patients with type 2 diabetes as they are associated with low hypoglycemia rates, weight loss and improved glycemic control. This study compared, in the Spanish setting, the cost-effectiveness of liraglutide 1.8 mg versus lixisenatide 20 μg, both GLP-1 receptor agonists, for patients with type 2 diabetes who had not achieved glycemic control targets on metformin monotherapy.MethodsThe IMS CORE Diabetes Model was used to project clinical outcomes and costs, expressed in 2015 Euros, over patient lifetimes. Baseline cohort data and treatment effects were taken from the 26-week, open-label LIRA-LIXI™ trial (NCT01973231). Treatment and management costs of diabetes-related complications were retrieved from published sources and databases. Future benefits and costs were discounted by 3% annually. Sensitivity analyses were conducted.ResultsCompared with lixisenatide 20 μg, liraglutide 1.8 mg was associated with higher life expectancy (14.42 vs. 14.29 years), higher quality-adjusted life expectancy [9.40 versus 9.26 quality-adjusted life years (QALYs)] and a reduced incidence of diabetes-related complications. Higher acquisition costs resulted in higher total costs for liraglutide 1.8 mg (EUR 42,689) than for lixisenatide 20 μg (EUR 42,143), but these were partly offset by reduced costs of treating diabetes-related complications (EUR 29,613 vs. EUR 30,636). Projected clinical outcomes and costs resulted in an incremental cost-effectiveness ratio of EUR 4113 per QALY gained for liraglutide 1.8 mg versus lixisenatide 20 μg.ConclusionsLong-term projections in the Spanish setting suggest that liraglutide 1.8 mg is likely to be cost-effective compared with lixisenatide 20 μg in type 2 diabetes patients who have not achieved glycemic control targets on metformin monotherapy. Liraglutide 1.8 mg presents a clinically and economically attractive treatment option in the Spanish setting.

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“…The base-case analysis results in an ICER close to €30,000 per QALY gained, which is typically considered an acceptable level for public funding in the Spanish setting [30][31][32]. The scenario analyses indicate that the ICER drops significantly below this threshold when a slightly different clinical practice or less conservative assumptions are considered.…”

Section: Discussionmentioning

confidence: 89%

Cost-effectiveness of Intrathecal Baclofen Therapy in severe refractory non-focal disabling spasticity: a Spanish hospital perspective

Vidal

Slof

Serrano³

et al. 2016

Expert Review of Pharmacoeconomics & Outcomes Research

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The Use of Quality-Adjusted Life-Years in the Economic Evaluation of Health Technologies in Spain: A Review of the 1990–2009 Literature

Abstract: An increasing number of economic evaluations using QALYs had been conducted. Most of them relied on theoretical models. Several methodological issues remain unsolved. Great disparity exists regarding the reporting of the methods used to determine health states and utility values.

Cited by 14 publications

References 30 publications

Economic and epidemiologic impact of guidelines for early ART initiation irrespective of CD4 count in Spain

Economic and epidemiologic impact of guidelines for early ART initiation irrespective of CD4 count in Spain

Liraglutide Versus Lixisenatide: Long-Term Cost-Effectiveness of GLP-1 Receptor Agonist Therapy for the Treatment of Type 2 Diabetes in Spain

Cost-effectiveness of Intrathecal Baclofen Therapy in severe refractory non-focal disabling spasticity: a Spanish hospital perspective

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