Estimating The Reference Icer For Australia And Public Perceptions Toward Its Use

• Published in: Value in health 2017-10, Vol.20 (9), p.A685
• Main Authors: Edney, LC, Haji Ali Afzali, H, Cheng, T, Karnon, J
• Format: Article
• Language: English
• Subjects: Community involvement; Cost analysis; Decision making; Health economics; Health status; Medical technology; Money; Morbidity; Mortality; New technology; Polls & surveys; Quality adjusted life years; Quality of life; Regression analysis
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.1728

OBJECTIVES: Economic evaluations are used to help determine whether new health technologies represent value for money. Under a fixed budget, an empirical estimate of the opportunity cost of funding decisions provides a reference value below which the Incremental Cost-Effectiveness Ratio (ICER) of a new technology can be considered value for money. A key barrier to adopting the estimated opportunity cost as a reference ICER in decision making is the perceived negative community response. METHODS: National data on healthcare spending and mortality outcomes are used to estimate the per capita mortality-related QALY gains using Instrumental Variable Two-Stage Least Squares regression. Population-level change in Health-Related Quality of Life (HRQoL) is estimated using a fixed effects model from a longitudinal, panel survey to generate per capita morbidity-related QALY gains.The reference ICER is estimated from the combined per capita mortality- and morbidity-related QALY gains. Community preference for price reductions and willingness to accept potential consequences are sought using a nationally representative online survey. RESULTS: Results indicated that healthcare spending had a significant impact on mortality-related QALYs lost (β=-1.6, p