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Managed Care: An Introduction
Published in A.F. Al-Assaf, Managed Care Quality, 2020
Managed care plans most often use outside data to compare their costs with other plans. Cost analysis for medical services involves many variables which must be considered before a true cost can be calculated. These variables include population demographics of the insureds with identification of the benefits package for each insured. Utilization may vary widely according to the type benefits the group has. Diagnosed illness is an important variable, from which, when combined with population demographics, the incidence rates for diagnosed illnesses can be calculated. Prescribed treatment regimen can be analyzed for identification of those regimen which are cost effective and have consistently positive outcomes. Within this process is an identification of the resources consumed for treatment. These variables combined can produce a picture of provider activity, i.e., physician profiling, to see which practitioners are effective and efficient. In turn, the plan can combine data into a “report card” of plan activity and compare against other plans.
Economy of Engineering-Medicine Education
Published in Lawrence S. Chan, William C. Tang, Engineering-Medicine, 2019
As we did for the cost analysis, we will also define the following analytical assumptions: Effectiveness will be defined by the healthcare saving in dollar terms, whether it is accomplished by increased efficiency or by reducing cost (Reid et al. 2005).
Pharmacoeconomics
Published in Conrad Harris, Jane Richards, Prescribing in General Practice, 2018
Cost minimization analysis, a type of cost analysis, is an appropriate evaluation method when the case for a clinical intervention has been established and the preventative, diagnostic or therapeutic procedures or programmes under consideration are expected to have exactly the same outcome (e.g. to prescribe a branded drug or a generic equivalent that costs half as much – the outcomes for both will be identical, and the only comparison is the cost).
A systematic review of economic analyses of home-based telerehabilitation
Published in Disability and Rehabilitation, 2022
Alisa Grigorovich, Min Xi, Natascha Lam, Maureen Pakosh, Brian C. F. Chan
Economic analyses are used to evaluate different health care intervention options by exploring their associated costs (avoided, direct, and indirect) or effects (health outcomes). In some cases, where the intervention or the treatment population is novel, there is no appropriate alternative treatment for comparison. The scope of costs and consequences included in the evaluation will depend upon the economic perspective that is taken in the analysis (i.e., the party who is incurring or saving costs through the implementation of an intervention), which can be the hospital/health care institution, the health care payer, the patient, or society as a whole [14]. Where clinical outcomes are similar between alternative health care interventions, economic analyses may simply compare the incremental upfront monetary investment of providing the intervention as compared to “usual care” [15]. A more comprehensive cost analysis would also include the downstream incremental economic impacts of providing the intervention such as reductions in health resource utilization (e.g., rehospitalization, physician visits). However, in most cases, different health care intervention options will have different clinical outcomes. In these circumstances, the appropriate analysis would compare both the costs and effects that may result from providing the intervention as compared to its alternative; these analyses are called “full economic evaluations” [15].
Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) Statement: Updated Reporting Guidance for Health Economic Evaluations
Published in Journal of Medical Economics, 2022
Don Husereau, Michael Drummond, Federico Augustovski, Esther de Bekker-Grob, Andrew H. Briggs, Chris Carswell, Lisa Caulley, Nathorn Chaiyakunapruk, Dan Greenberg, Elizabeth Loder, Josephine Mauskopf, C. Daniel Mullins, Stavros Petrou, Raoh-Fang Pwu, Sophie Staniszewska
The CHEERS 2022 statement is intended to be used for any form of health economic evaluation.43 This includes analyses that only examine costs and cost offsets (that is, cost analysis) or those that examine both costs and consequences. The latter include analyses that consider health consequences (such as, cost-effectiveness/utility analyses (CEAs/CUAs), cost minimization, cost-benefit/benefit-cost analyses (CBAs)), and broader measures of benefit and harm to individuals (such as extended CEAs/CBAs), including measures of equity (such as distributional CEAs). While we are aware some studies comparing costs are labelled as CBAs, we recommend the use of this term for studies which include a monetary valuation of health outcomes. Although linked to economic evaluation, budget impact analyses and constrained optimization studies are beyond the scope of CHEERS guidance, as they require additional reporting that addresses population dynamics and feasibility constraints and are addressed in other guidance reports.44,45
Pharmacoeconomics of allergy immunotherapy versus pharmacotherapy
Published in Expert Review of Clinical Immunology, 2021
Four systematic reviews have evaluated the cost-effectiveness of AIT compared with SDT [13,49,50,51]. Two of the reviews focused on allergic rhinitis and two considered asthma and AR. One of the reviews only considered the grass-pollen AIT [51]. One of the most comprehensive and rigorous systematic reviews was conducted by the National Institute for Health Research Health Technology Assessment (HTA) program [13]. The HTA program serves to produce high-quality research information on the cost-effectiveness impact of health technologies for the UK’s National Health Service (NHS). The HTA systematic review evaluated randomized controlled trials that compared SDT with SCIT (5 studies) [52–56], SLIT (6 studies) [48,57–61], or both SCIT and SLIT (3 studies) [24,62,63] published through April 2011. The authors identified 14 Economic Evaluations (EE) that utilized four different methods of cost analysis. Four different types of cost-analyses were used in the 14 identified EE studies: cost-effectiveness analyses (CEA), cost-consequences analyses (CCA), cost-utility analyses (CUA), and cost-benefit analyses (CBA) (see Table 2 for the description of economic evaluations). Six studies considered a societal perspective, five studies considered a combination of perspectives, and two studies considered the health insurer perspective. One study did not state the perspective used.