Talk:Economic evaluation: Difference between revisions
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:'' Some previous discussion about the economic model is [http://en.opasnet.org/en-opwiki/index.php?title=Talk:Economic_evaluation&oldid=33638 archived here]. | |||
== Economic comparison method == | == Economic comparison method == | ||
{{discussion | {{discussion | ||
|Statements = The following comparison methods should be used in comparing the | |Statements = The following comparison methods should be used in comparing the tenders: | ||
# Incremental cost-effectiveness (ICER) | # Incremental cost-effectiveness (ICER) | ||
# Cost-effectiveness with a limit value harmonized in all health care | # Cost-effectiveness with a limit value harmonized in all health care | ||
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{{attack|# |There should be only one primary comparison method. Therefore all options should be rejected a priori and specific reasons should be presented to use a method.|--[[User:Jouni|Jouni]] ([[User talk:Jouni|talk]]) 04:04, 5 September 2014 (UTC)}} | {{attack|# |There should be only one primary comparison method. Therefore all options should be rejected a priori and specific reasons should be presented to use a method.|--[[User:Jouni|Jouni]] ([[User talk:Jouni|talk]]) 04:04, 5 September 2014 (UTC)}} | ||
# Incremental cost-effectiveness (ICER) | # Incremental cost-effectiveness (ICER) | ||
#: {{defend|# |This is the preferred method, because the society has not set an exchange rate between money and health | #: {{defend|# |This is the preferred method, because the society has not set an exchange rate between money and health (or QALY). Such a rate would be necessary for performing cost-benefit analysis and cost-effectiveness analysis with limit value.|--THL 3 July 2014}} | ||
#: {{defend|# |Implicit support from comment GSK1.|--[[User:Jouni|Jouni]] ([[User talk:Jouni|talk]]) 04:04, 5 September 2014 (UTC)}} | #: {{defend|# |Implicit support from comment GSK1.|--[[User:Jouni|Jouni]] ([[User talk:Jouni|talk]]) 04:04, 5 September 2014 (UTC)}} | ||
#: {{comment|# |This method was unpopular in a [[:op_fi:Pneumokokkorokotekysely|related questionnaire]].|--[[User:Jouni|Jouni]] ([[User talk:Jouni|talk]]) 04:04, 5 September 2014 (UTC)}} | #: {{comment|# |This method was unpopular in a [[:op_fi:Pneumokokkorokotekysely|related questionnaire]].|--[[User:Jouni|Jouni]] ([[User talk:Jouni|talk]]) 04:04, 5 September 2014 (UTC)}} | ||
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{{comment|K2 |Should willingness to pay/QALY be at the same level as applied in health care in Finland, i.e. 50 000-66 000 €/QALY? <ref>Soini et al 2012</ref> <ref>Leussu 2011.</ref>|--Pfizer Oy, 2014-08-27 13:47:39 - R upload}} | {{comment|K2 |Should willingness to pay/QALY be at the same level as applied in health care in Finland, i.e. 50 000-66 000 €/QALY? <ref>Soini et al 2012</ref> <ref>Leussu 2011.</ref>|--Pfizer Oy, 2014-08-27 13:47:39 - R upload}} | ||
: {{attack|Heini1 | In Finland, there is no threshold for the cost of an additional quality-adjusted life-year. In the light of recent experience of varicella vaccination programme the decision makers’ willingness to pay for a QALY was not 50 000-66 000 euros. From the health care payers perspective varicella vaccination programme was cost-effective (14 600 euros / QALY) and from the societal perspective it was cost-saving. There are favourable recommendations of experts (Expert group, National Advisory Committee for Vaccination) and even a decision of Ministry of Social Affairs and Health to propose Government funding for varicella vaccination as part of the national immunization programme. However, Varicella vaccination has not yet been approved in the Government's budget proposal.|--[[User:Heini|Heini]] ([[User talk:Heini|talk]]) 12:35, 2 September 2014 (UTC)}} | : {{attack|Heini1 | In Finland, there is no threshold for the cost of an additional quality-adjusted life-year. In the light of recent experience of varicella vaccination programme the decision makers’ willingness to pay for a QALY was not 50 000-66 000 euros. From the health care payers' perspective varicella vaccination programme was cost-effective (14 600 euros / QALY) and from the societal perspective it was cost-saving. There are favourable recommendations of experts (Expert group, National Advisory Committee for Vaccination) and even a decision of Ministry of Social Affairs and Health to propose Government funding for varicella vaccination as part of the national immunization programme. However, Varicella vaccination has not yet been approved in the Government's budget proposal.|--[[User:Heini|Heini]] ([[User talk:Heini|talk]]) 12:35, 2 September 2014 (UTC)}} | ||
'''Question: | '''Comments about Question: | ||
* "The health benefit (effectiveness) of the pneumococcal infant immunisation programme is assessed by the expected gain in Quality-Adjusted Life Years (QALYs), corresponding to the expected reduction in the annual number of invasive pneumococcal disease in the whole Finnish population." | * "The health benefit (effectiveness) of the pneumococcal infant immunisation programme is assessed by the expected gain in Quality-Adjusted Life Years (QALYs), corresponding to the expected reduction in the annual number of invasive pneumococcal disease in the whole Finnish population." | ||
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::While we acknowledge that the it may be difficult to adjust the epidemiological model to assess the impact and benefits of prevention of respiratory infection episodes, including pneumonia and acute otitis media related endpoints, which effectively represent majority of the vaccine preventable disease burden (e.g.Palmu, ESPID 2014, poster), it is imperative that the cost effectiveness analyses take into account these endpoints. | ::While we acknowledge that the it may be difficult to adjust the epidemiological model to assess the impact and benefits of prevention of respiratory infection episodes, including pneumonia and acute otitis media related endpoints, which effectively represent majority of the vaccine preventable disease burden (e.g.Palmu, ESPID 2014, poster), it is imperative that the cost effectiveness analyses take into account these endpoints. | ||
::To consider only IPDs would distort the cost-effectiveness analysis and by ignoring the majority of cost savings would violate the procurement law requirement that the selection criteria must have economic relevance to the contracting entity | ::To consider only IPDs would distort the cost-effectiveness analysis and by ignoring the majority of cost savings would violate the procurement law requirement that the selection criteria must have economic relevance to the contracting entity.|-- GSK 13:17, 3 September 2014 (UTC)}} | ||
:::{{attack|Kauq1|We refer to our replies to the same discussion on pages [[Talk:Comparison_criteria|Comparison criteria]] and [[Talk: Epidemiological_modelling|Epidemiological modelling]]. It should be noted that the tendering criteria are geared towards comparing different vaccine products. Critical assumptions about individual serotype’s expected efficacy or effectiveness have been assessed in sensitivy analyses.|Kauq, Sep 6, 2014}} | |||
:: {{attack|GSK2 |Further, as indicated in the section [[Comparison_criteria|Comparison criteria]] the assumption for serotype specific vaccine effectiveness for vaccine and vaccine-related types should be based on available clinical evidence, as far as possible. In consequence, some parameters explored in the sensitivity analysis should be rather considered as a base case assumptions.|-- GSK 13:17, 3 September 2014 (UTC)}} | |||
'''Other comments | |||
{{defend|GSK3|The applicants should have the opportunity to submit their proposal for assumptions including scientific justification and/or to provide alternative models for consideration. It is proposed to invite applicants to address such issues [as mentioned in comment GSK2] in the tender submissions.|-- GSK 13:17, 3 September 2014 (UTC)}} | |||
:{{defend|Kauq2|The open discussion on these pages provides the forum for all stakeholders to express their views.|Kauq, Sep 6, 2014}} | |||
== References == | == References == | ||
<references/> | <references/> | ||
Latest revision as of 12:02, 8 September 2014
- Some previous discussion about the economic model is archived here.
Economic comparison method
| Fact discussion: . |
|---|
Opening statement: The following comparison methods should be used in comparing the tenders:
Closing statement: ICER should be used. (A closing statement, when resolved, should be updated to the main page.) |
| Argumentation:
⇤--#: . There should be only one primary comparison method. Therefore all options should be rejected a priori and specific reasons should be presented to use a method. --Jouni (talk) 04:04, 5 September 2014 (UTC) (type: truth; paradigms: science: attack)
|
Comments
----K2: . Should willingness to pay/QALY be at the same level as applied in health care in Finland, i.e. 50 000-66 000 €/QALY? [1] [2] --Pfizer Oy, 2014-08-27 13:47:39 - R upload (type: truth; paradigms: science: comment)
- ⇤--Heini1: . In Finland, there is no threshold for the cost of an additional quality-adjusted life-year. In the light of recent experience of varicella vaccination programme the decision makers’ willingness to pay for a QALY was not 50 000-66 000 euros. From the health care payers' perspective varicella vaccination programme was cost-effective (14 600 euros / QALY) and from the societal perspective it was cost-saving. There are favourable recommendations of experts (Expert group, National Advisory Committee for Vaccination) and even a decision of Ministry of Social Affairs and Health to propose Government funding for varicella vaccination as part of the national immunization programme. However, Varicella vaccination has not yet been approved in the Government's budget proposal. --Heini (talk) 12:35, 2 September 2014 (UTC) (type: truth; paradigms: science: attack)
Comments about Question:
- "The health benefit (effectiveness) of the pneumococcal infant immunisation programme is assessed by the expected gain in Quality-Adjusted Life Years (QALYs), corresponding to the expected reduction in the annual number of invasive pneumococcal disease in the whole Finnish population."
- ⇤--GSK1: . PCV programmes have been demonstrated to deliver much broader public health and economic benefits which extend beyond reduction of the invasive disease.
- While we acknowledge that the it may be difficult to adjust the epidemiological model to assess the impact and benefits of prevention of respiratory infection episodes, including pneumonia and acute otitis media related endpoints, which effectively represent majority of the vaccine preventable disease burden (e.g.Palmu, ESPID 2014, poster), it is imperative that the cost effectiveness analyses take into account these endpoints.
- To consider only IPDs would distort the cost-effectiveness analysis and by ignoring the majority of cost savings would violate the procurement law requirement that the selection criteria must have economic relevance to the contracting entity. -- GSK 13:17, 3 September 2014 (UTC) (type: truth; paradigms: science: attack)
- ⇤--Kauq1: . We refer to our replies to the same discussion on pages Comparison criteria and Epidemiological modelling. It should be noted that the tendering criteria are geared towards comparing different vaccine products. Critical assumptions about individual serotype’s expected efficacy or effectiveness have been assessed in sensitivy analyses. Kauq, Sep 6, 2014 (type: truth; paradigms: science: attack)
- ⇤--GSK2: . Further, as indicated in the section Comparison criteria the assumption for serotype specific vaccine effectiveness for vaccine and vaccine-related types should be based on available clinical evidence, as far as possible. In consequence, some parameters explored in the sensitivity analysis should be rather considered as a base case assumptions. -- GSK 13:17, 3 September 2014 (UTC) (type: truth; paradigms: science: attack)
Other comments
←--GSK3: . The applicants should have the opportunity to submit their proposal for assumptions including scientific justification and/or to provide alternative models for consideration. It is proposed to invite applicants to address such issues [as mentioned in comment GSK2] in the tender submissions. -- GSK 13:17, 3 September 2014 (UTC) (type: truth; paradigms: science: defence)
- ←--Kauq2: . The open discussion on these pages provides the forum for all stakeholders to express their views. Kauq, Sep 6, 2014 (type: truth; paradigms: science: defence)