5 Economic Evaluation

Question 1

what are the types of evaluations?

Answer 1

cost-utility analysis (CUA)
—- outcomes expressed as quality-adjusted life years (QALY)

cost-effectiveness analysis (CEA)
—- outcomes expressed in natural units (e.g. life-years gained, lives saved, or clinical event avoided/achieved)

cost-minimization analysis (CMA)
—- interventions being compared are considered equivalent in terms of all relevant outcomes

cost-consequence analysis (CCA)
—- costs and outcomes are presented in disaggregated form

cost-benefit analysis (CBA)
—- outcomes expressed in monetary terms

Question 2

how should an economic evaluation be done?

Answer 2

economic evaluation should be a cost-utility analysis (CUA) with outcomes expressed as quality-adjusted life-years (QALYs)

Question 3

describe the cost-effectiveness analysis (CEA)

Answer 3

a cost-effectiveness analysis with outcomes expressed in natural units is not an appropriate reference case.

if convincing evidence is available to show that
important patient outcomes are equivalent on virtually
all measures, except for survival or quality of life, then a CUA remains the appropriate approach.

allows for the necessary comparison, using the
same benefit metric, across all the technologies being
considered.

Question 4

describe the cost-minimization analysis (CMA)

Answer 4

a cost-minimization analysis (CMA) is a costing exercise and not a formal economic evaluation

as such, a CMA is not an appropriate reference case
analysis.

CUA remains the appropriate approach, even where convincing evidence is available to show that important outcomes are similar, as it allows for the analysis of the uncertainty in incremental effect (through probabilistic analysis), facilitating the necessary comparison across all
technologies.

Question 5

describe the cost consequence analysis

Answer 5

a cost-consequence analysis (CCA) should be viewed as a complement to, and not a substitute far, a CUA.

CCA aids in the transparency of the reporting of an economic evaluation, as
disaggregated results are presented in terms of costs and outcomes (e.g., events predicted, survival, gains in quality of life).