An estimation of the costs of producing an incremental QALY for patients suffering acute ischemic stroke in Denmark

Abstract

Formål: Formålet med opgaven er at estimere omkostningerne ved at producere et inkrementelt kvalitets-justeret leveår (QALY) for patienter med akut iskæmisk apopleksi i Danmark. Dette kan bruges til at vurdere alternativomkostningerne i den danske sund-hedssektor.Metode: En Markov model bruges til at estimere omkostninger i DKK og effekt i QALY af to alternativer, hvoraf det ene afspejler den nuværende behandlingsstandard og det an-det afspejler et hypotetisk scenarie, hvor sygdommen ikke behandles. I analysen tages et begrænset samfundsperspektiv og parametrene til modellen bliver primært fundet gennemflere systematiske litteratursøgninger.Resultat: Resultaterne viser, at omkostningerne ved at producere en inkrementel QALYi Danmark er DKK 224.146,62. På grund af antagelser er der dog usikkerheder forbundet med dette estimat.Diskussion: Først diskuteres de metoder, der er blevet brugt til at estimere omkostninger og effekt af alternativerne. Dette efterfølges af en sammenligning af denne opgave med lignende studier. Størstedelen af diskussionen omhandler vigtigheden i at prioritere i sund-hedssektoren og måder hvorpå en tærskelværdi for omkostningseffektivitet kan estimeres.Konklusion: Omkostningerne ved at producere en inkrementel QALY i Danmark er DKK224.146,62. Fremtidig forskning bør tage udgangspunkt i at undersøge andre sygdomsom-råder, så alternativomkostningerne i det danske sundhedsvæsen kan blive estimeret

Objective: The aim of this project is to estimate the costs of producing one incremental quality-adjusted life year (QALY) in Denmark for patients suffering acute ischemic stroke (AIS). This will be used to assess opportunity costs in the Danish health care sector. Methods:A Markov model is used to estimate costsand QALY for two alternatives; one reflecting the current treatment of AIS and one reflecting a hypothetical alternative with no treatment strategy. A limited societal perspective is taken, and input parameters for the model are primarily found through systematic literature searches. Results:The results show that the costs per incremental QALY is DKK 224,146.62. However, due to assumptions, a large uncertainty on the results is present. Discussion:Firstly, methods used for estimating costsand QALY are discussed, followed by a comparison to other studies. This is a novel way of using a Markovmodel to estimate opportunity costs. The method is exact in estimating costs of AIS, but has low generalizability and can not be transferred directly to other areas. Lastly, the importance of prioritization in healthcare is emphasized. Conclusion:In Denmark, the costs of producing one incremental QALY for AIS patients are DKK224,146.62. Further research in different disease areas is needed to estimate opportunity costs in the Danish health care sector.

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An estimation of the costs of producing an incremental QALY for patients suffering acute ischemic stroke in Denmark - A discussion of opportunity costs