Understanding the global measurement of willingness to pay in health

McDougall, Jean A.; Furnback, Wesley; Wang, Bruce C.M.; Mahlich, Jörg

doi:10.1080/20016689.2020.1717030

Cited by 93 publications

(87 citation statements)

References 41 publications

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“…No strategies using remdesivir monotherapy were favoured and in most cases were less effective and more costly than other strategies in the base-case. Multivariate analysis showed that remdesivir for moderate and dexamethasone for severe infections remained the preferred choice when willingness to pay thresholds are over $37,500 USD, which is a relevant threshold in countries such as Canada, Ireland, Australia, Spain and the United Kingdom 16 .…”

Section: Discussionmentioning

confidence: 99%

Treatment of Moderate to Severe Respiratory COVID-19—A Cost-Utility Analysis

Congly

Varughese

Brown

et al. 2020

Preprint

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Background: Due to COVID-19's significant morbidity and mortality, identifying the most cost-effective pharmacologic treatment strategy is critical. As such, we determined the most cost-effective strategy for moderate to severe COVID-19 respiratory infections using the United States health care system as a representative model. Methods: A decision analytic model modelled a base case scenario of a 60-year-old patient admitted to hospital with COVID-19. Patients requiring oxygen were considered moderate severity, and patients with severe COVID-19 required intubation with intensive care. Strategies modelled included giving remdesivir to all patients, remdesivir in severe infections, remdesivir in moderate infections, dexamethasone to all patients, dexamethasone in severe infections, remdesivir in moderate/dexamethasone in severe infections, and best supportive care. Data for the model came from the published literature. The time horizon was 1 year; no discounting was performed due to the short duration. The perspective was of the payer in the United States health care system. Results: Supportive care for moderate/severe COVID-19 cost $11,112.98/0.8256 QALY. Remdesivir in moderate/dexamethasone in severe infections was the most cost-effective with an incremental cost-effectiveness ratio of $19,764.56/QALY gained compared to supportive care. Probabilistic sensitivity analyses showed remdesivir for moderate/dexamethasone for severe COVID-19 infection was most cost-effective in 88.6% of scenarios and dexamethasone in moderate-severe infections in 11.4% of scenarios. With lower willingness to pay thresholds ($250-$37,500), dexamethasone for severe infections was favoured. Conclusions: Remdesivir for moderate/dexamethasone for severe COVID-19 infections was the most cost-effective strategy. Further data is required for remdesivir to better assess its cost effectiveness in treatment of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Treatment of Moderate to Severe Respiratory COVID-19—A Cost-Utility Analysis

Congly

Varughese

Brown

et al. 2020

Preprint

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“…Country-specific willingness-to-pay thresholds are difficult to determine from available evidence as various methodologies exist. 18 The World Health Organization CHOICE (CHOosing Interventions that are Cost-Effective) project has recommended thresholds of 1–3 times the gross domestic product (GDP) per capita, with those interventions meeting the <1 GDP threshold considered highly cost-effective. 19 Therefore, we examined the cost-effectiveness at WTP thresholds of near 1 GDP (~$40,000 in UAE) and 3 GDP per capita (~$120,000 in UAE).…”

Section: Resultsmentioning

confidence: 99%

Evaluating the Cost-Effectiveness of Celecoxib versus Ibuprofen and Naproxen in Patients with Osteoarthritis in United Arab Emirates Based on the PRECISION Trial

Chirikov

Walker²,

Stephens

et al. 2021

CEOR

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Objective: Data on osteoarthritis patients from the PRECISION trial were used to evaluate the cost-effectiveness of celecoxib (100 mg twice daily) versus ibuprofen (600-800 mg three times daily) and naproxen (375-500 mg twice daily). The perspective was that of the United Arab Emirates (UAE) healthcare system. Methods: Discrete-state Markov model with monthly cycles, 30-month horizon, and 3% discount rate was constructed to assess incremental costs per quality adjusted life year (QALYs) gained from reduced incidence of three safety domains examined in PRECISION: renal, serious gastrointestinal (GI), and major adverse cardiovascular events (MACE). Costs for managing these toxicities were derived from Dubai Administrative Billing Claims (2018). Median monthly drug costs were derived from UAE Ministry of Health and Prevention's

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“…This threshold is equivalent to 1 GDP per capita in Colombia. The Colombian methodological guide for economic evaluations established this threshold to consider a technology highly cost-effective following the recommendations of the World Health Organization [ 28 , 49 , 50 ].…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of nonoperative management versus open and laparoscopic surgery for uncomplicated acute appendicitis in Colombia

Guevara-Cuéllar

Rengifo-Mosquera

Parody-Rúa

2021

Cost Eff Resour Alloc

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Background Traditionally, uncomplicated acute appendicitis (AA) has been treated with appendectomy. However, the surgical alternatives might carry out significant complications, impaired quality of life, and higher costs than nonoperative treatment. Consequently, it is necessary to evaluate the different therapeutic alternatives' cost-effectiveness in patients diagnosed with uncomplicated appendicitis. Methods We performed a model-based cost-effectiveness analysis comparing nonoperative management (NOM) with open appendectomy (OA) and laparoscopic appendectomy (LA) in patients otherwise healthy adults aged 18–60 years with a diagnosis of uncomplicated AA from the payer´s perspective at the secondary and tertiary health care level. The time horizon was 5 years. A discount rate of 5% was applied to both costs and outcomes. The health outcomes were quality-adjusted life years (QALYs). Costs were identified, quantified, and valorized from a payer perspective; therefore, only direct health costs were included. An incremental analysis was estimated to determine the incremental cost-effectiveness ratio (ICER). In addition, the net monetary benefit (NMB) was calculated for each alternative using a willingness to pay lower than one gross domestic product. A deterministic and probabilistic sensitivity analysis was performed. Methods We performed a model-based cost-effectiveness analysis comparing nonoperative management (NOM) with open appendectomy (OA) and laparoscopic appendectomy (LA) in patients otherwise healthy adults aged 18–60 years with a diagnosis of uncomplicated AA from the payer’s perspective at the secondary and tertiary health care level. The time horizon was five years. A discount rate of 5% was applied to both costs and outcomes. The health outcomes were quality-adjusted life years (QALYs). Costs were identified, quantified, and valorized from a payer perspective; therefore, only direct health costs were included. An incremental analysis was estimated to determine the incremental cost-effectiveness ratio (ICER). In addition, the net monetary benefit (NMB) was calculated for each alternative using a willingness to pay lower than one gross domestic product. A deterministic and probabilistic sensitivity analysis was performed. Results LA presents a lower cost ($363 ± 35) than OA ($384 ± 41) and NOM ($392 ± 44). NOM exhibited higher QALYs (3.3332 ± 0.0276) in contrast with LA (3.3310 ± 0.057) and OA (3.3261 ± 0.0707). LA dominated the OA. The ICER between LA and NOM was $24,000/QALY. LA has a 52% probability of generating the highest NMB versus its counterparts, followed by NOM (30%) and OA (18%). There is a probability of 0.69 that laparoscopy generates more significant benefit than medical management. The mean value of that incremental NMB would be $93.7 per patient. Conclusions LA is a cost-effectiveness alternative in the management of patients with uncomplicated AA. Besides, LA has a high probability of producing more significant monetary benefits than NOM and OA from the payer’s perspective in the Colombian health system.

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Understanding the global measurement of willingness to pay in health

Cited by 93 publications

References 41 publications

Treatment of Moderate to Severe Respiratory COVID-19—A Cost-Utility Analysis

Treatment of Moderate to Severe Respiratory COVID-19—A Cost-Utility Analysis

Evaluating the Cost-Effectiveness of Celecoxib versus Ibuprofen and Naproxen in Patients with Osteoarthritis in United Arab Emirates Based on the PRECISION Trial

Cost-effectiveness analysis of nonoperative management versus open and laparoscopic surgery for uncomplicated acute appendicitis in Colombia

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