Skip header and navigation

Refine By

65 records – page 1 of 7.

An experimental test of a theoretical foundation for rating-scale valuations.

https://arctichealth.org/en/permalink/ahliterature14259
Source
Med Decis Making. 1997 Apr-Jun;17(2):208-16
Publication Type
Article
Author
H. Bleichrodt
M. Johannesson
Author Affiliation
Department of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands. bleichrodt@econ.bmg.eur.nl
Source
Med Decis Making. 1997 Apr-Jun;17(2):208-16
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - classification
Adult
Arthritis, Rheumatoid - diagnosis
Cost-Benefit Analysis
Decision Support Techniques
Female
Health status
Humans
Male
Netherlands
Outcome and Process Assessment (Health Care) - statistics & numerical data
Quality-Adjusted Life Years
Reproducibility of Results
Sweden
Abstract
A major advantage of using a rating scale in health-utility measurement is its practical applicability: the method is relatively easy to understand, and various health states can be assessed simultaneously. However, a theoretical foundation for rating-scale valuations has not been established. The primary aim of this paper is to present a theoretical foundation for rating-scale valuations based on the theory of measurable value functions and to provide a consistency test to see whether rating-scale valuations do indeed elicit a measurable value function. If rating-scale valuations elicit a measurable value function, then Dyer and Sarin have shown how they are related to von Neumann-Morgensterm (vNM) utilities. The appropriate technique to measure vNM utilities is the standard gamble. Torrance has suggested that rating-scale valuations and standard-gamble valuations are related by a power function. A secondary aim of this paper is to examine the relationship between rating-scale valuations and standard-gamble valuations hypothesized by Torrance. An experiment was designed to test consistency of rating-scale valuations and the relationship between rating-scale valuations and standard-gamble valuations. The experiment tested whether rating-scale valuations are independent of the context in which they are elicited, as they should be if they elicit points on a measurable value function. 80 Swedish and 92 Dutch respondents participated in the experiment. The results showed that rating-scale valuations depend on the number of preferred alternatives in the task and thus violate a basic property of measurable value functions. The estimation of the power function did not result in stable results: parameter estimates varied, in some cases there was indication of misspecification, and in most cases there was indication of heteroskedastic errors. The implications of these findings for the common use of rating-scale valuations in cost-utility analysis are serious: the dependency of the rating-scale valuations on the other health states included in the task casts serious doubts on the validity of the rating-scale method.
Notes
Comment In: Med Decis Making. 1998 Apr-Jun;18(2):2369566457
PubMed ID
9107617 View in PubMed
Less detail

At what coronary risk level is it cost-effective to initiate cholesterol lowering drug treatment in primary prevention?

https://arctichealth.org/en/permalink/ahliterature52363
Source
Eur Heart J. 2001 Jun;22(11):919-25
Publication Type
Article
Date
Jun-2001
Author
M. Johannesson
Author Affiliation
Centre for Health Economics, Stockholm School of Economics, Stockholm, Sweden.
Source
Eur Heart J. 2001 Jun;22(11):919-25
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Antilipemic Agents - economics - therapeutic use
Comparative Study
Coronary Disease - drug therapy - economics - prevention & control
Cost-Benefit Analysis - economics - methods
Female
Humans
Male
Middle Aged
Risk factors
Sensitivity and specificity
Sex Factors
Sweden - epidemiology
Abstract
BACKGROUND: The entire risk factor profile should be taken into account when considering initiating cholesterol lowering drug treatment. Recent treatment guidelines are therefore based on the absolute risk of coronary heart disease. We estimated at what coronary risk it is cost-effective to initiate cholesterol lowering drug treatment in primary prevention for men and women of different ages in Sweden. METHODS: The cost-effectiveness was estimated as the incremental cost per quality-adjusted life-year (QALY) gained of cholesterol lowering drug treatment. Treatment was assumed to lower the risk of coronary heart disease by 31%. The analysis was carried out from a societal perspective including both direct and indirect costs of the intervention and morbidity, and the full future costs of decreased mortality. The coronary risk, in a Markov model of coronary heart disease, was raised until the cost per QALY gained corresponded to a specific threshold value per QALY gained. Three different threshold values were used: $40,000, $60,000 and $100,000 per QALY gained. RESULTS: The risk cut-off value for when treatment is cost-effective varied with age and gender. If society is willing to pay $60,000 to gain a QALY it was cost-effective to initiate treatment if the 5-year-risk of coronary heart disease exceeded 2.4% for 35-year-old men, 4.6% for 50-year-old men, and 10.4% for 70-year-old men. The corresponding risk cut-off values for women were 2.0%, 3.5% and 9.1%. CONCLUSIONS: The results can serve as a basis for treatment guidelines based on cost-effectiveness.
PubMed ID
11428815 View in PubMed
Less detail

A comparison of patient and social tariff values derived from the time trade-off method.

https://arctichealth.org/en/permalink/ahliterature72285
Source
Health Econ. 1999 Sep;8(6):541-5
Publication Type
Article
Date
Sep-1999
Author
N. Zethraeus
M. Johannesson
Author Affiliation
Department of Economics, Stockholm School of Economics, Stockholm, Sweden. henz@hhs.se
Source
Health Econ. 1999 Sep;8(6):541-5
Date
Sep-1999
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Female
Hormone Replacement Therapy - economics
Humans
Menopause
Middle Aged
Patient Acceptance of Health Care
Quality-Adjusted Life Years
Social Values
Statistics, nonparametric
Sweden
Treatment Outcome
Abstract
A social tariff of EuroQol time trade-off (TTO) values was recently presented. We compared the social tariff and patient TTO values among 104 women with mild and severe menopausal symptoms. The social tariff and patient TTO values were elicited both after and before hormone replacement therapy (HRT). There was a close correspondence between social-tariff values and patient TTO values for relatively good health states, whereas the social tariff TTO values were lower than the patient TTO values for severe health states.
PubMed ID
10544319 View in PubMed
Less detail

A computer model to analyze the cost-effectiveness of hormone replacement therapy.

https://arctichealth.org/en/permalink/ahliterature200706
Source
Int J Technol Assess Health Care. 1999;15(2):352-65
Publication Type
Article
Date
1999
Author
N. Zethraeus
M. Johannesson
B. Jönsson
Author Affiliation
Stockholm School of Economics.
Source
Int J Technol Assess Health Care. 1999;15(2):352-65
Date
1999
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Computer simulation
Cost-Benefit Analysis
Estrogen Replacement Therapy - adverse effects - economics - methods - psychology
Female
Humans
Life expectancy
Middle Aged
Monte Carlo Method
Quality of Life
Quality-Adjusted Life Years
Reproducibility of Results
Risk factors
Sweden - epidemiology
Abstract
This paper gives a detailed presentation of a computer model for evaluating the cost-effectiveness (CE) of hormone replacement therapy (HRT), describing the model's design, structure, and data requirements. The model needs data specified for costs, quality of life, risks, and mortality rates. As an illustration, the CE of HRT in Sweden is calculated. Two treatment strategies are evaluated for asymptomatic women: estrogen-only therapy and estrogen combined with a progestin. The model produces similar results compared with earlier studies. The CE ratios improve with the size of the risk reduction and generally with age. Further, estrogen-only therapy is associated with a lower cost per gained effectiveness unit compared with combined therapy. Uncertainty surrounding the long-term effects of HRT means that the CE estimates should be interpreted carefully. The model permits the inclusion of indirect costs and costs in added life-years, allowing the analysis to be made from a societal perspective, which is an improvement relative to previous studies.
PubMed ID
10507194 View in PubMed
Less detail

The contingent valuation controversy in environmental economics and its relevance to health services research.

https://arctichealth.org/en/permalink/ahliterature212394
Source
J Health Serv Res Policy. 1996 Apr;1(2):116-7
Publication Type
Article
Date
Apr-1996
Author
M. Johannesson
Author Affiliation
Centre for Health Economics, Stockholm School of Economics, Sweden.
Source
J Health Serv Res Policy. 1996 Apr;1(2):116-7
Date
Apr-1996
Language
English
Publication Type
Article
Keywords
Attitude to Health
Conservation of Natural Resources - economics
Consumer Satisfaction - economics
Cost-Benefit Analysis
Decision Making
Health Care Sector
Health Services Research - economics
Humans
Sweden
PubMed ID
10180850 View in PubMed
Less detail

Contingent valuation with an open-ended follow-up question: a test of scope effects.

https://arctichealth.org/en/permalink/ahliterature206583
Source
Health Econ. 1997 Nov-Dec;6(6):637-9
Publication Type
Article
Author
B. Kartman
N O Stålhammar
M. Johannesson
Source
Health Econ. 1997 Nov-Dec;6(6):637-9
Language
English
Publication Type
Article
Keywords
Esophagitis, Peptic - economics - therapy
Financing, Personal
Health Priorities - economics
Humans
Least-Squares Analysis
Likelihood Functions
Logistic Models
Models, Econometric
Sweden
Abstract
It has been suggested that an open-ended follow-up question should be added to the binary contingent valuation question. Before this is generally recommended, it is important to evaluate the properties of such follow-up questions. Using a split sample approach, we test whether the open-ended follow-up is sensitive to the scope of the commodity being valued. No significant scope effects were detected. It is concluded that the results obtained do not support the use of an open-ended follow-up in contingent valuation applications.
PubMed ID
9466145 View in PubMed
Less detail

Cost-effectiveness analysis and capital costs.

https://arctichealth.org/en/permalink/ahliterature205783
Source
Soc Sci Med. 1998 May;46(9):1183-91
Publication Type
Article
Date
May-1998
Author
G. Karlsson
M. Johannesson
Author Affiliation
Stockholm School of Economics, Sweden.
Source
Soc Sci Med. 1998 May;46(9):1183-91
Date
May-1998
Language
English
Publication Type
Article
Keywords
Budgets
Capital Expenditures
Cost-Benefit Analysis - methods
Decision Making, Organizational
Decision Support Techniques
Health Care Costs
Humans
Investments - economics
Linear Models
Models, Econometric
Quality-Adjusted Life Years
Sweden
Abstract
Traditionally, economic evaluations in terms of cost-effectiveness analysis are based, explicitly or implicitly, on the assumption of constant returns to scale. This assumption has been criticized in the literature and the role of cost-effectiveness as a tool for decision making has been questioned. In this paper we analyze the case of increasing returns to scale due to fixed capital costs. Cost-effectiveness analysis is regarded as a tool for estimating a cost function. To this cost function two types of decision rules can be applied, the budget approach and the constant price approach. It is shown that in the presence of fixed capital costs the application of these two decision rules to a specific patient group will give different results. The budget approach may lead to suboptimizations, while using the price as a decision rule will give optimal solutions. With fixed capital costs and when an investment can be used for treating several patient groups, these groups are no longer independent. Therefore the cost-effectiveness analysis has to be performed simultaneously for all patient groups that are potential users of the investment.
PubMed ID
9572608 View in PubMed
Less detail

Cost-effectiveness analysis of hypertension treatment--a review of methodological issues.

https://arctichealth.org/en/permalink/ahliterature225889
Source
Health Policy. 1991 Sep;19(1):55-77
Publication Type
Article
Date
Sep-1991
Author
M. Johannesson
B. Jönsson
Author Affiliation
Department of Health and Society, Linköping University, Sweden.
Source
Health Policy. 1991 Sep;19(1):55-77
Date
Sep-1991
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - economics
Cost-Benefit Analysis - methods - statistics & numerical data
Female
Humans
Hypertension - drug therapy - economics - epidemiology
Male
Middle Aged
Models, Theoretical
Quality of Life
Sweden - epidemiology
Treatment Outcome
Value of Life
Abstract
There is a lack of methodological conformity in cost-effectiveness analyses of hypertension treatment. They differ with respect to assumptions about the effectiveness of treatment, the outcome measure chosen, the cost-concept, the discounting of effects and the duration of therapy. The aim of this paper is to review these issues and estimate the importance of different assumptions for the cost per life-year gained. To analyse these assumptions a computer simulation model was constructed based on the Framingham logistic risk equations and Swedish cost data. It is shown that the cost per life-year gained is highly sensitive towards many of these assumptions. It is also shown that the average cost-effectiveness ratios calculated in previous studies and the relevant marginal cost-effectiveness ratios can differ by several hundred per cent. The results of cost-effectiveness analyses in the hypertension field have to be interpreted with caution. Due to the lack of standardized methodology, the comparability between studies is limited. There is also a need to complement cost-effectiveness analysis in this area with other approaches, for example based on WTP.
PubMed ID
10117392 View in PubMed
Less detail

The cost-effectiveness of a cardiovascular multiple-risk-factor intervention programme in treated hypertensive men.

https://arctichealth.org/en/permalink/ahliterature48410
Source
J Intern Med. 1995 Jan;237(1):19-26
Publication Type
Article
Date
Jan-1995
Author
M. Johannesson
S. Agewall
M. Hartford
T. Hedner
B. Fagerberg
Author Affiliation
Centre For Health Economics, Stockholm School of Economics, Sweden.
Source
J Intern Med. 1995 Jan;237(1):19-26
Date
Jan-1995
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - economics
Behavior Therapy - economics
Cost-Benefit Analysis
Humans
Hypertension - drug therapy - economics - etiology - therapy
Male
Middle Aged
Outpatient Clinics, Hospital - economics
Patient Education - economics
Referral and Consultation - economics
Research Support, Non-U.S. Gov't
Risk factors
Sensitivity and specificity
Sweden
Value of Life
Abstract
OBJECTIVES. The aim of this study was to carry out a cost-effectiveness analysis of a multifactorial intervention programme in treated hypertensive patients. DESIGN. A cost-effectiveness analysis based on 3 years of follow-up in an open, randomized, parallel-group study with allocation either to a comprehensive, multiple-risk factor modification programme or to conventional treatment. SETTING. An outpatient clinic of a city hospital. SUBJECTS. Inclusion criteria were: male sex, age 50-72 (mean 66.4) years, treated hypertension and at least one of the following: serum cholesterol > or = 6.5 mmol L-1, and/or smoking and/or diabetes mellitus. A total of 508 patients were included in the study. INTERVENTIONS. Advice given to individuals, and group meetings based on nutritional advice and behavioural treatment principles. If necessary, drug therapy could be instituted to achieve the treatment goals in the intervention group: serum total cholesterol of
Notes
Comment In: J Intern Med. 1995 Jan;237(1):1-37830021
PubMed ID
7830026 View in PubMed
Less detail

Cost-effectiveness of cholesterol lowering. Results from the Scandinavian Simvastatin Survival Study (4S)

https://arctichealth.org/en/permalink/ahliterature211591
Source
Eur Heart J. 1996 Jul;17(7):1001-7
Publication Type
Article
Date
Jul-1996
Author
B. Jönsson
M. Johannesson
J. Kjekshus
A G Olsson
T R Pedersen
H. Wedel
Author Affiliation
For the Scandinavian Simvastatin Survival Study Group, Stockholm School of Economics, Sweden.
Source
Eur Heart J. 1996 Jul;17(7):1001-7
Date
Jul-1996
Language
English
Publication Type
Article
Keywords
Anticholesteremic Agents - economics - therapeutic use
Case-Control Studies
Clinical Trials as Topic
Coronary Disease - drug therapy - economics
Cost of Illness
Cost-Benefit Analysis
Evaluation Studies as Topic
Humans
Hypercholesterolemia - drug therapy
Lovastatin - analogs & derivatives - economics - therapeutic use
Prospective Studies
Reproducibility of Results
Scandinavia
Simvastatin
Survival Rate
Abstract
An analysis of the cost-effectiveness of simvastatin was conducted, based on the Scandinavian Simvastatin Survival Study (4S). The total cost of hospitalization in the placebo group was 52.8 million Swedish kronor (SEK) (5.15 million pounds), compared with SEK 36.0 million (3.51 million pounds) in the simvastatin group. This amounts to a 32% reduction, or a saving of SEK 16.8 million (1.6 million pounds) or SEK 7560 (738 pounds) per patient. The net cost per patient for the duration of the study (5.4 years) was SEK 13,540 (1324 pounds). Simvastatin treatment saved an estimated 0.377 undiscounted life years (0.240 life years discounted at 5% per annum). The cost of simvastatin therapy per discounted life-year saved was therefore SEK 56,400 (5502 pounds). Sensitivity analysis, examining the effect of different life expectancies, costs of initiation and monitoring of simvastatin therapy, and discount rates, showed the results to be stable. Conclusion. The cost per life-year saved of simvastatin in the treatment of post-myocardial infarction and angina patients, as determined from 4S data, is well within the range normally considered cost-effective.
Notes
Comment In: Eur Heart J. 1996 Jul;17(7):974-58809507
PubMed ID
8809516 View in PubMed
Less detail

65 records – page 1 of 7.