The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Milton C. Weinstein - One of the best experts on this subject based on the ideXlab platform.
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Medicare and Cost-Effectiveness analysis.
The New England journal of medicine, 2005Co-Authors: Peter J. Neumann, Allison B. Rosen, Milton C. WeinsteinAbstract:In this article, the authors discuss the obstacles to the use of Cost-Effectiveness analysis in Medicare decisions about coverage. They argue that policymakers could avert the impending financial crisis facing Medicare by incorporating Cost-Effectiveness analysis into a comprehensive strategy to allocate health care resources more rationally.
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evaluating the Cost Effectiveness of clinical and public health measures
Annual Review of Public Health, 1998Co-Authors: John D Graham, Phaedra S Corso, Jill M Morris, Maria Seguigomez, Milton C. WeinsteinAbstract:Cost-Effectiveness analysis, an analytic tool that expresses as a ratio the Cost of obtaining an additional unit of health outcome, can help decision makers achieve more health protection for the same or less Cost. We characterize the state of the Cost-Effectiveness analysis literature by reviewing how this technique is applied to various clinical and public health interventions. We describe the results of Cost-Effectiveness analyses for over 40 interventions to reduce cancer, heart disease, trauma, and infectious disease. The Cost-Effectiveness ratios for these interventions vary enormously, from interventions that save money to those that Cost more than $1 million per year of life gained. The methods used to derive the Cost-Effectiveness ratios also vary considerably, and we summarize this variation within each health area. Greater uniformity of analytical practice will be necessary if Cost-Effectiveness analysis is to become a more influential tool in debates about resource allocation.
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recommendations for reporting Cost Effectiveness analyses panel on Cost Effectiveness in health and medicine
JAMA, 1996Co-Authors: Joanna E Siegel, Milton C. Weinstein, Louise B Russell, Marthe R GoldAbstract:Objective This article, the third in a 3-part series, describes recommendations for the reporting of Cost-effective analyses (CEAs) intended to improve the quality and accessibility of CEA reports. Participants The Panel on Cost-Effectiveness in Health and Medicine, a nonfederal panel with expertise in CEA, clinical medicine, ethics, and health outcomes measurement, convened by the US Public Health Service. Evidence The panel reviewed the theoretical foundations of CEA, current practices, alternative methods, published critiques of CEAs, and criticisms of general CEA methods and reporting practices. Consensus process The panel developed recommendations through 2 1/2 years of discussions. Comments on preliminary drafts were solicited from federal government methodologists, health agency officials, and academic methodologists. Conclusions These recommendations are proposed to enhance the transparency of study methods, assist analysts in providing complete information, and facilitate the presentation of comparable Cost-Effectiveness results across studies. Adherence to reporting conventions and attention to providing information required to understand and interpret study results will improve the relevance and accessibility of CEAs.
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recommendations for reporting Cost Effectiveness analyses
JAMA, 1996Co-Authors: Joanna E Siegel, Milton C. Weinstein, Louise B Russell, Marthe R GoldAbstract:Objective. —This article, the third in a 3-part series, describes recommendations for the reporting of Cost-effective analyses (CEAs) intended to improve the quality and accessibility of CEA reports. Participants. —The Panel on Cost-Effectiveness in Health and Medicine, a nonfederal panel with expertise in CEA, clinical medicine, ethics, and health outcomes measurement, convened by the US Public Health Service. Evidence. —The panel reviewed the theoretical foundations of CEA, current practices, alternative methods, published critiques of CEAs, and criticisms of general CEA methods and reporting practices. Consensus Process. —The panel developed recommendations through 21/2 years of discussions. Comments on preliminary drafts were solicited from federal government methodologists, health agency officials, and academic methodologists. Conclusion. —These recommendations are proposed to enhance the transparency of study methods, assist analysts in providing complete information, and facilitate the presentation of comparable Cost-Effectiveness results across studies. Adherence to reporting conventions and attention to providing information required to understand and interpret study results will improve the relevance and accessibility of CEAs.
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the role of Cost Effectiveness analysis in health and medicine panel on Cost Effectiveness in health and medicine
JAMA, 1996Co-Authors: Louise B Russell, Joanna E Siegel, Marthe R Gold, Norman Daniels, Milton C. WeinsteinAbstract:Objective: To develop consensus-based recommendations guiding the conduct of Cost-Effectiveness analysis (CEA) to improve the comparability and quality of studies. The recommendations apply to analyses intended to inform the allocation of health care resources across a broad range of conditions and interventions. This article, first in a 3-part series, discusses how this goal affects the conduct and use of analyses. The remaining articles will outline methodological and reporting recommendations, respectively. Participants: The Panel on Cost-Effectiveness in Health and Medicine, a nonfederal panel with expertise in CEA, clinical medicine, ethics, and health outcomes measurement, was convened by the US Public Health Service (PHS). Evidence: The panel reviewed the theoretical foundations of CEA, current practices, and alternative procedures for measuring and assigning values to resource use and health outcomes. Consensus process: The panel met 11 times during 2 1/2 years with PHS staff and methodologists from federal agencies. Working groups brought issues and preliminary recommendations to the full panel for discussion. Draft recommendations were circulated to outside experts and the federal agencies prior to finalization. Conclusions: The panel's recommendations define a "reference case" Cost-Effectiveness analysis, a standard set of methods to serve as a point of comparison across studies. The reference case analysis is conducted from the societal perspective and accounts for benefits, harms, and Costs to all parties. Although CEA does not reflect every element of importance in health care decisions, the information it provides is critical to informing decisions about the allocation of health care resources.
M Orrell - One of the best experts on this subject based on the ideXlab platform.
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Cognitive stimulation therapy for people with dementia: Cost-Effectiveness analysis
The British Journal of Psychiatry, 2006Co-Authors: M OrrellAbstract:Background: Psychological therapy groups for people with dementia are widely used, but their Cost-Effectiveness has not been explored. Aims: To investigate the Cost-Effectiveness of an evidence-based cognitive stimulation therapy (CST) programme for people with dementia as part of a randomised controlled trial. Method: A total of 91 people with dementia, living in care homes or the community, received a CST group intervention twice weekly for 8 weeks; 70 participants with dementia received treatment as usual. Service use was recorded 8 weeks before and during the 8-week intervention and Costs were calculated. A Cost-Effectiveness analysis was conducted with cognition as the primary outcome, and quality of life as the secondary outcome. Cost-Effectiveness acceptability curves were plotted. Results: Cognitive stimulation therapy has benefits for cognition and quality of life in dementia, and Costs were not different between the groups. Under reasonable assumptions, there is a high probability that CST is more Cost-effective than treatment as usual, with regard to both outcome measures. Conclusions: Cognitive stimulation therapy for people with dementia has Effectiveness advantages over, and may be more Cost-effective than, treatment as usual.
Alex R Kemper - One of the best experts on this subject based on the ideXlab platform.
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estimated Cost Effectiveness of growth hormone therapy for idiopathic short stature
JAMA Pediatrics, 2006Co-Authors: Joyce M Lee, Matthew M Davis, Sarah J Clark, Timothy P Hofer, Alex R KemperAbstract:Objective To estimate the Cost-Effectiveness of growth hormone (GH) therapy for idiopathic short stature (ISS). Design Cost-Effectiveness analysis. Setting Decision model. Patients A cohort of 10-year-old prepubertal boys with ISS treated with GH. Interventions Comparison of children treated for 5 years with GH therapy vs children receiving no intervention. Main Outcome Measures Incremental Cost per child, incremental growth per child, and incremental Cost per inch of final height gain. Results The estimated incremental Cost-Effectiveness ratio of GH therapy for ISS in the base case analysis compared with no therapy was $52 634 per inch (per 2.54 cm), or $99 959 per child, reflecting an incremental growth of 1.9 in (4.8 cm). Alternate treatment strategies such as increased duration of GH treatment and high pubertal dosing of GH did not substantially improve the Cost-Effectiveness ratio. Probabilistic sensitivity analyses showed that growth variability in response to GH had the greatest impact on the Cost-Effectiveness of GH therapy. Conclusions Targeted treatment of children with ISS with the greatest potential for growth appears critical for maximizing Cost-Effectiveness of GH treatment. However, the significance of the Cost per inch is difficult to judge until the utility gains associated with height gain after GH therapy for ISS can be ascertained.
Syed Rizvi - One of the best experts on this subject based on the ideXlab platform.
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Cost Effectiveness of spinal cord stimulation therapy in management of chronic pain
Pain Medicine, 2013Co-Authors: Krishna Kumar, Syed RizviAbstract:Objective. To evaluate the Cost-Effectiveness of spinal cord stimulation (SCS) and conventional medical management (CMM) compared with CMM alone for patients with failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), peripheral arterial disease (PAD), and refractory angina pectoris (RAP). Design. Markov models were developed to evaluate the Cost-Effectiveness of SCS vs CMM alone from
Garry Barton - One of the best experts on this subject based on the ideXlab platform.
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cognitive behaviour therapy for improving social recovery in psychosis Cost Effectiveness analysis
Schizophrenia Research, 2009Co-Authors: Garry Barton, Jo Hodgekins, Miranda Mugford, Peter Jones, Tim Croudace, David FowlerAbstract:Abstract A randomised trial was conducted in order to estimate the clinical and Cost-Effectiveness of social recovery orientated cognitive behavioural therapy (SRCBT) for people diagnosed with psychosis, compared to case management alone (CMA). The mean incremental health and social care Cost, and the mean incremental quality adjusted life year (QALY) gain, of SRCBT was calculated over the 9 month intervention period. The Cost-Effectiveness of SCRBT was in turn estimated, and considered in relation to the Cost-Effectiveness threshold of £20 000 per QALY. The level of uncertainty associated with that decision was estimated by calculating the Cost-Effectiveness acceptability curve for SRCBT. N = 35 received SRCBT and N = 42 received CMA. The mean incremental Cost was estimated to be £668, and the mean incremental QALY gain 0.035. SRCBT was estimated to be Cost-effective as it had a Cost per QALY of £18 844, which was more favourable than the assumed Cost-Effectiveness threshold of £20 000 per QALY. At that threshold the probability of being Cost-effective was however estimated to be 54.3% according to the CEAC, suggesting that further research may be warranted in order to reduce the level of uncertainty associated with the decision as to whether SRCBT is Cost-effective.
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optimal Cost Effectiveness decisions the role of the Cost Effectiveness acceptability curve ceac the Cost Effectiveness acceptability frontier ceaf and the expected value of perfection information evpi
Value in Health, 2008Co-Authors: Garry Barton, Andrew Briggs, Elisabeth FenwickAbstract:Objective: To demonstrate how the optimal decision and level of uncertainty associated with that decision, can be presented when assessing the Cost-Effectiveness of multiple options. To explore and explain potentially counterintuitive results that can arise when analyzing multiple options. Methods: A template was created, based on the assumption of multivariate normality, in order to replicate a previous analysis that compared the Cost-Effectiveness of multiple options. We used this template to explain some of the different shapes that the Cost-Effectiveness acceptability curve (CEAC), Cost-Effectiveness acceptability frontier (CEAF), and expected value of perfection information (EVPI) may take, with changing correlation structure and variance between the multiple options. Results: We show that it is possible for 1) an option that is subject to extended dominance to have the highest probability of being Cost-effective for some values of the Cost-Effectiveness threshold; 2) the most Cost-effective (optimal) option to never have the highest probability of being Cost-effective; and 3) the EVPI to increase when the probability of making the wrong decision decreases. Changing the correlation structure between multiple options did not change the presentation of results on the Cost-Effectiveness plane. Conclusion: The Cost-Effectiveness plane has limited use in representing the uncertainty surrounding multiple options as it cannot represent correlation between the options. CEACs can represent decision uncertainty, but should not be used to determine the optimal decision. Instead, the CEAF shows the decision uncertainty surrounding the optimal choice and this can be augmented by the EVPI to show the potential gains to further research.
