Change search
ReferencesLink to record
Permanent link

Direct link
Compilation of cost-effectiveness evidence for different heart conditions and treatment strategies
Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.ORCID iD: 0000-0002-9375-5087
Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
2011 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, Vol. 45, no 2, 72-76 p.Article, review/survey (Refereed) Published
Abstract [en]

Objectives. Despite the continuing interest in health economic research, we could find no accessible data set on cost-effectiveness, useful as practical information to decision makers who must allocate scarce resources within the cardiovascular field. The aim of this paper was to present cost-effectiveness ratios, based on a systematic literature search for the treatment of heart diseases. Design. A comprehensive literature search on cost-effectiveness analyses of intervention strategies for the treatment of heart diseases was conducted. We compiled available cost-effectiveness ratios for different heart conditions and treatment strategies, in a cost-effectiveness ranking table. The cost-effectiveness ratios were expressed as a cost per quality adjusted life year (QALY) or life year gained. Results. Cost-effectiveness ratios, ranging from dominant to those costing more than 1,000,000 Euros per QALY gained, and bibliographic references are provided for. The table was categorized according to disease group, making the ranking table readily available. Conclusions. Cost-effectiveness ranking tables provide a means of presenting cost-effectiveness evidence. They provide valid information within a limited space aiding decision makers on the allocation of health care resources. This paper represents an extensive compilation of health economic evidence for the treatment of heart diseases.

Place, publisher, year, edition, pages
Informa Healthcare , 2011. Vol. 45, no 2, 72-76 p.
Keyword [en]
Cost, cost-effectiveness, rankings, heart disease, priority setting, evidence-based medicine
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-67153DOI: 10.3109/14017431.2011.557438ISI: 000288326200002OAI: oai:DiVA.org:liu-67153DiVA: diva2:407809
Note
Original Publication: Nathalie Eckard, Magnus Janzon and Lars-Åke Levin, Compilation of cost-effectiveness evidence for different heart conditions and treatment strategies, 2011, Scandinavian Cardiovascular Journal, (45), 2, 72-76. http://dx.doi.org/10.3109/14017431.2011.557438 Copyright: Informa Healthcare http://informahealthcare.com/ Available from: 2011-04-01 Created: 2011-04-01 Last updated: 2015-09-11
In thesis
1. The matter of economic evaluations in health policy decision-making: The case of the Swedish national guidelines for heart diseases
Open this publication in new window or tab >>The matter of economic evaluations in health policy decision-making: The case of the Swedish national guidelines for heart diseases
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Economic evaluations are used to inform decision makers about the efficient allocation of scarce healthcare resources and are generated with the direct intent to support decisions in healthcare. Producing guidelines is a complex process and the inclusion of health-economic aspects in the formulation of the Swedish national guidelines as a basis for the written recommendations (priority gradings), distinguishes them from their European counterparts. Despite the increased use of cost-effectiveness data in decision-making, little is known about the actual use of such data. This thesis covers issues concerning how economic evaluations matter in health policy decision-making. The thesis includes four papers based on the Swedish national guidelines for heart diseases, one of the most prominent examples in Sweden of following the notion of evidence-based policy (EBP), in order to inform explicit priority setting.

Both Papers I and II followed a qualitative case study design, based on the same data set. Paper I explored how a specific working group, the Priority Setting Group (PSG), handled the various forms of evidence and values when producing the national guidelines. Two themes were identified in reaching collective agreement in priority gradings; group facilitation activities and avoiding deadlock in the discussion. The work process involved disagreement and negotiation as part of that task. Paper I contributes to the theoretical and practical debate on EBP. Paper II focused on the use of cost-effectiveness data as decision support in the PSG work process. The paper addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. Three themes were identified. The paper contributes to knowledge on how cost-effectiveness evidence was used in actual decision-making. The use of cost-effectiveness evidence was one of many tools employed to avoid deadlock in discussion and to reach a priority grading, when the overall evidence base was weak, in times of uncertainty and on the introduction of new expensive medical technologies.

Quantitative research methods were used for both Papers III and IV. Paper III explored how the PSG was presented with cost-effectiveness evidence as decision support and as a basis for their priority gradings. Cost-effectiveness ratios (ICERs) were provided, based on a  systematic literature review, as well as how the results may be conveyed and communicated, for the treatment of heart diseases using a cost-effectiveness ranking or league and providing valid information within a limited space, aiding decision makers on the allocation of healthcare resources. The thesis also includes decision support in the form of cost-effectiveness analysis on catheter ablation treatment. Paper IV provides an example of presenting evidence in the form of a decision-analytic model. The modelling approach provides an analytic framework for decision-making, specifically under conditions of uncertainty as in the introduction of new medical technology. Catheter ablation was associated with reduced cost and an incremental gain in quality adjusted life years (QALYs), and was considered a cost-effective treatment strategy compared to the medical treatment strategy in a lifetime perspective.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 119 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1440
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-121282 (URN)10.3384/diss.diva-121282 (DOI)978-91-7519-142-3 (print) (ISBN)
Public defence
2015-10-02, Eken, Ingång 65, Campus US, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2015-09-11 Created: 2015-09-11 Last updated: 2015-09-11Bibliographically approved

Open Access in DiVA

fulltext(404 kB)556 downloads
File information
File name FULLTEXT01.pdfFile size 404 kBChecksum SHA-512
52dbd5321e41bb64c5037d80f06ef59177c3afb1f584fcbc305ac78d96a791729eea9f34bbd0cbb69daf1b8d7e017da0ab496c33c8abfe6b6b538c49c291d68d
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Eckard, NathalieJanzon, MagnusLevin, Lars-Åke
By organisation
Health Technology Assessment and Health EconomicsFaculty of Health SciencesCardiologyDepartment of Cardiology UHL
In the same journal
Scandinavian Cardiovascular Journal
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 556 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 131 hits
ReferencesLink to record
Permanent link

Direct link