Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
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To evaluate the cost-effectiveness of treatment with anti-CD20 monoclonal antibody obinutuzumab plus chlorambucil (GClb) in untreated patients with chronic lymphocytic leukemia unsuitable for full-dose fludarabine-based therapy. ⋯ GClb was estimated to increase both quality-adjusted life expectancy and treatment costs compared with several commonly used therapies, with incremental cost-effectiveness ratios below commonly referenced UK thresholds. This article offers a real example of how to combine direct and indirect evidence in a cost-effectiveness analysis of oncology drugs.
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To develop an algorithm for estimating EuroQol five-dimensional questionnaire (EQ-5D)-equivalent utilities from the chronic obstructive pulmonary disease (COPD) assessment test (CAT) and evaluate its use in economic evaluations as part of health technology assessments for COPD. ⋯ In the absence of EQ-5D data, the OLS regression algorithm may provide an estimate of utility for treatment models, but it is likely to underestimate treatment effects. Therefore, it is recommended that utilities be derived directly from the EQ-5D for the purposes of health technology assessments for COPD treatments in the United Kingdom.
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There is broad support to pay for value, rather than volume, for health care in the United States. Despite the support, practical approaches for measuring value remain elusive. ⋯ Academicians have proposed a conceptual approach to measure value, in which we measure outcomes important to patients and costs using time-driven activity-based costing. This approach is conceptually sound, but has significant practical challenges. In our commentary, we describe how health care can use existing quality measures and cost accounting data to measure value. Although not perfect, we believe this approach is practical, valid, and scalable and can establish the foundation for future work in this area.