Evidence map›Paper›PMID 29273843›Full record

ArticlePharmacoEconomics2018

Estimating the Reference Incremental Cost-Effectiveness Ratio for the Australian Health System.

Laura Catherine Edney, Hossein Haji Ali Afzali, Terence Chai Cheng, Jonathan Karnon

Abstract read
PubMed Publisher
In one paragraph

Article in PharmacoEconomics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
104citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

104 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Factors associated with the author-reported cost-effectiveness threshold in high-income countries: systematic review and multivariable modelling.The European journal of health economics : HEPAC : health economics in prevention and care · 2024
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  14. Cost-effectiveness of an Environmental Cleaning Bundle for Reducing Healthcare-associated Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020
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44 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Laura Catherine EdneySchool of Public Health, University of Adelaide, Level 9, Adelaide Health and Medical Sciences Building, Adelaide, SA, 5005, Australia. laura.edney@adelaide.edu.au.ORCID 0000-0002-2447-4118
Hossein Haji Ali AfzaliSchool of Public Health, University of Adelaide, Level 9, Adelaide Health and Medical Sciences Building, Adelaide, SA, 5005, Australia.ORCID 0000-0002-0198-8394
Terence Chai ChengSchool of Economics, University of Adelaide, Level 4, 10 Pulteney Street, Adelaide, SA, 5005, Australia.ORCID 0000-0001-5561-8412
Jonathan KarnonSchool of Public Health, University of Adelaide, Level 9, Adelaide Health and Medical Sciences Building, Adelaide, SA, 5005, Australia.ORCID 0000-0003-3220-2099

Funding

NHMRC Project Grant 108-4387
6 · The paper itself

Abstract

backgroundSpending on new healthcare technologies increases net population health when the benefits of a new technology are greater than their opportunity costs-the benefits of the best alternative use of the additional resources required to fund a new technology.

objectiveThe objective of this study was to estimate the expected incremental cost per quality-adjusted life-year (QALY) gained of increased government health expenditure as an empirical estimate of the average opportunity costs of decisions to fund new health technologies. The estimated incremental cost-effectiveness ratio (ICER) is proposed as a reference ICER to inform value-based decision making in Australia.

methodsEmpirical top-down approaches were used to estimate the QALY effects of government health expenditure with respect to reduced mortality and morbidity. Instrumental variable two-stage least-squares regression was used to estimate the elasticity of mortality-related QALY losses to a marginal change in government health expenditure. Regression analysis of longitudinal survey data representative of the general population was used to isolate the effects of increased government health expenditure on morbidity-related, QALY gains. Clinical judgement informed the duration of health-related quality-of-life improvement from the annual increase in government health expenditure.

resultsThe base-case reference ICER was estimated at AUD28,033 per QALY gained. Parametric uncertainty associated with the estimation of mortality- and morbidity-related QALYs generated a 95% confidence interval AUD20,758-37,667.

conclusionRecent public summary documents suggest new technologies with ICERs above AUD40,000 per QALY gained are recommended for public funding. The empirical reference ICER reported in this article suggests more QALYs could be gained if resources were allocated to other forms of health spending.

Indexed as

Quality-Adjusted Life YearsAustraliaBiomedical TechnologyCost-Benefit AnalysisDecision MakingDelivery of Health CareFinancing, GovernmentHealth ExpendituresHumansLeast-Squares AnalysisQuality of LifeRegression AnalysisTechnology Assessment, Biomedical

Identifiers

PMID29273843

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.