Cost per QALYS Treatment treatment gained Heart Disease A B 100 300 D 400 E 600 12 800 15 Cancer G H 200 400 10 500 12 K 600 L. 700 14 M 800 15 Infectious Discase N 100 2 350 4 R 650 6
. The health authorities are considering the treatment
alternatives for three types of diseases: heart disease,
cancer, and infectious disease. Each year there are
10,000 new cases of heart disease, 10,000 new cases
of cancer, and 5,000 new cases of infectious disease.
For each diagnosis, there are a number of mutually
independent treatment alternatives (including no
treatment) as shown in the following table.
a. Identify all dominant treatment alternatives.
Explain why each is dominant.
b. Calculate the incremental cost, incremental
QALYs, and ICERs for all economically
rational strategies (ICER 5 incremental cost
/incremental QALYs). Why are these considered
economically rational?
c. Using separate graphs for heart disease, cancer,
and infectious disease, show the alternative
treatment options, label the dominant options,
and show the economically feasible alternatives.
(Place QALYs on the vertical axis and cost per
treatment on the horizontal axis.)
d. The local health district has asked your opinion on the “best” strategy from a public health
perspective (disease covered, treatment strategy). What do you tell them? How much will it
cost?
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