An estimation of the costs of producing an incremental QALY for patients suffering acute ischemic stroke in Denmark - A discussion of opportunity costs
Authors
Frederiksen, Cecilie Astrup ; Slot, Matilde
Term
4. term
Publication year
2020
Submitted on
2020-05-26
Pages
85
Abstract
Formål: Dette projekt estimerer, hvad det koster at producere ét ekstra kvalitetsjusteret leveår (QALY) – et mål, der kombinerer, hvor længe man lever, og hvor godt man lever – for personer i Danmark med akut iskæmisk apopleksi (AIS), en blodprop i hjernen. Estimatet skal bruges til at belyse alternativomkostninger i det danske sundhedsvæsen (hvad man må undvære, når ressourcer bruges ét sted frem for et andet). Metoder: En Markov-model – en trinvis simulering af helbredstilstande over tid – bruges til at beregne omkostninger og QALY for to scenarier: den nuværende behandling af AIS og et hypotetisk scenarie uden behandling. Analysen anvender et begrænset samfundsperspektiv, og de fleste modelinput er fundet via systematiske litteratursøgninger. Resultater: Den estimerede omkostning pr. ekstra QALY er DKK 224,146.62. Fordi analysen bygger på flere antagelser, er der betydelig usikkerhed om estimatet. Diskussion: Metoderne til at estimere omkostninger og QALY diskuteres og sammenlignes med andre studier. Arbejdet præsenterer en ny måde at anvende en Markov-model til at estimere alternativomkostninger. Tilgangen er præcis for AIS-relaterede omkostninger, men har lav generaliserbarhed og kan ikke overføres direkte til andre sygdomsområder. Studiet understreger også vigtigheden af prioritering i sundhedsvæsenet. Konklusion: I Danmark anslås det at koste DKK 224,146.62 at producere én ekstra QALY for patienter med AIS. Der er behov for yderligere forskning på tværs af sygdomsområder for at belyse alternativomkostninger i det danske sundhedsvæsen.
Objective: This project estimates the cost of producing one additional quality-adjusted life year (QALY)—a measure that combines how long people live and how well they live—for people in Denmark who have an acute ischemic stroke (AIS), a stroke caused by a blocked blood vessel. The estimate is intended to inform opportunity costs in the Danish healthcare system (the trade-offs when resources are used for one treatment instead of another). Methods: We built a Markov model—a step-by-step simulation of health states over time—to calculate costs and QALYs for two scenarios: the current treatment of AIS and a hypothetical scenario with no treatment. The analysis uses a limited societal perspective, and most model inputs were identified through systematic literature searches. Results: The estimated cost per incremental QALY is DKK 224,146.62. Because several assumptions are required, there is substantial uncertainty around this estimate. Discussion: We discuss the methods used to estimate costs and QALYs and compare our findings with other studies. This work introduces a novel way to use a Markov model to estimate opportunity costs. The approach is precise for estimating AIS-related costs but has low generalizability and cannot be directly applied to other disease areas. The study also underscores the importance of prioritization in healthcare. Conclusion: In Denmark, producing one incremental QALY for patients with AIS is estimated to cost DKK 224,146.62. Further research across different diseases is needed to inform opportunity-cost estimates in the Danish healthcare sector.
[This abstract was generated with the help of AI]
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