Modelling cost-effectiveness from an international perspective
Economic evaluations are used widely to estimate the costs and consequences of competing care interventions. These range from cost studies – which compare the costs associated with alternative policy options – to cost-effectiveness analyses – which estimate incremental costs relative to differences in outcome measures such as Quality Adjusted Life Years (QALYs).
A key challenge for policy-makers is understanding how the results of evaluations can be generalised between countries. The unit costs of goods and services can vary considerably from an international perspective (Adam 2006, Chisholm and Knapp 2002, WHO 2010), potentially altering the relative costs or cost-effectiveness of competing intervention options. Probabilistic and deterministic sensitivity analyses are common in evaluations (NICE 2012). Usually, however, these draw on cost distributions framed within a domestic rather than international setting. This issue has received some attention in the context of health and pharmaceutical interventions (Barbieri et al 2005, Mogyorosy and Smith 2005), but is relatively unexplored in relation to long-term care.
The aim of this project was to investigate the sensitivity of cost estimates for long-term care interventions to international variations in unit costs. Results are presented in the form of an interactive online tool, allowing users to view and adjust country-specific unit costs for a series of models based on existing intervention studies.
The interactive models are intended as an exploratory tool rather than a robust prescriptive framework and are subject to a number of important data and methodological limitations. More information about methods and assumptions can be accessed below.
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