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Cured today, ill tomorrow: a method for including future unrelated medical costs in economic evaluation in England and Wales

Perry-Duxbury, Meg, Asaria, Miqdad ORCID: 0000-0002-3538-4417, Lomas, James and van Baal, Pieter (2020) Cured today, ill tomorrow: a method for including future unrelated medical costs in economic evaluation in England and Wales. Value in Health. ISSN 1098-3015

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Identification Number: 10.1016/j.jval.2020.05.006

Abstract

Objectives: In many countries, future unrelated medical costs occurring during life-years gained are excluded from economic evaluation, and benefits of unrelated medical care are implicitly included, leading to life-extending interventions being disproportionately favored over quality of life-improving interventions. This article provides a standardized framework for the inclusion of future unrelated medical costs and demonstrates how this framework can be applied in England and Wales. Methods: Data sources are combined to construct estimates of per-capita National Health Service spending by age, sex, and time to death, and a framework is developed for adjusting these estimates for costs of related diseases. Using survival curves from 3 empirical examples illustrates how our estimates for unrelated National Health Service spending can be used to include unrelated medical costs in cost-effectiveness analysis and the impact depending on age, life-years gained, and baseline costs of the target group. Results: Our results show that including future unrelated medical costs is feasible and standardizable. Empirical examples show that this inclusion leads to an increase in the ICER of between 7% and 13%. Conclusions: This article contributes to the methodology debate over unrelated costs and how to systematically include them in economic evaluation. Results show that it is both important and possible to include future unrelated medical costs.

Item Type: Article
Official URL: https://www.journals.elsevier.com/value-in-health
Additional Information: © 2020 ISPOR–The Professional Society for Health Economics and Outcomes Research
Divisions: LSE Health
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 15 Jun 2020 15:51
Last Modified: 28 Jul 2020 07:57
URI: http://eprints.lse.ac.uk/id/eprint/105084

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