Cost-Effectiveness Analysis Registry
Encyclopedia
The Cost-Effectiveness Analysis Registry was developed by the Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies, Tufts Medical Center
, Boston, MA. The Registry contains detailed information on over 2,800 cost-utility analyses published through 2010. Health-related CEAs estimate the resources used (costs) and the health benefits achieved (effects) for an intervention compared to an alternative treatment strategy. The Registry focuses on a subset of CEAs, called cost-utility analyses
(CUAs) that quantify health benefits in terms of quality-adjusted life years (QALYs), a metric that accounts for changes in both longevity and quality of life.
The CEA Registry contains data on articles published from 1976 through 2010, including information on more than 7000 ratios. The Registry website lists 30 academic papers based on the Registry data. It has been used or cited in analyses performed by the Environmental Protection Agency, the Food and Drug Administration
, the Institute of Medicine
, and the Medicare Payment Assessment Commission. The CEA Registry is also listed on the National Library of Medicine's website as a health economics resource.
The published articles summarized in the Registry undergo a formalized review protocol. These articles address a variety of diseases and treatments and all measure health effects in terms of the QALYs, a standard measure that accounts for quality of life (morbidity) and longevity (mortality
). The CEA Registry team searches MEDLINE
for English-language articles using keywords "QALYs", "quality-adjusted", and "cost-utility analysis". Abstracts from these articles are screened to determine if the paper contains an original cost-utility estimate. The team excludes review, editorial, or methodological articles, as well as cost-effectiveness analyses that do not use QALYs to quantify health benefits.
Each article meeting these criteria is assigned a disease classification by a clinician. Two readers with training in decision analysis
and cost-effectiveness analysis independently review each article and record information using a standardized set of forms and instructions. The two readers convene for a consensus audit to resolve any potential discrepancies. On occasion, a third reader may be called upon to help settle disputed items.
Data on over 40 variables is collected for each article.
For methodology, the registry reports
Tufts Medical Center
Tufts Medical Center is a medical institution in Boston, Massachusetts occupying space between Chinatown and the Theater District....
, Boston, MA. The Registry contains detailed information on over 2,800 cost-utility analyses published through 2010. Health-related CEAs estimate the resources used (costs) and the health benefits achieved (effects) for an intervention compared to an alternative treatment strategy. The Registry focuses on a subset of CEAs, called cost-utility analyses
Cost-utility analysis
Cost–utility analysis is a form of financial analysis used to guide procurement decisions. The most common and well-known application of this analysis is in pharmacoeconomics, especially health technology assessment .-CUA in health economics:...
(CUAs) that quantify health benefits in terms of quality-adjusted life years (QALYs), a metric that accounts for changes in both longevity and quality of life.
General information
The project website states that the objectives of the Registry are to help decision makers identify society's best opportunities for targeting resources to improve health, to assist policymakers in healthcare resource allocation decisions, and to move the field towards the use of standard methodologies.The CEA Registry contains data on articles published from 1976 through 2010, including information on more than 7000 ratios. The Registry website lists 30 academic papers based on the Registry data. It has been used or cited in analyses performed by the Environmental Protection Agency, the Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
, the Institute of Medicine
Institute of Medicine
The Institute of Medicine is a not-for-profit, non-governmental American organization founded in 1970, under the congressional charter of the National Academy of Sciences...
, and the Medicare Payment Assessment Commission. The CEA Registry is also listed on the National Library of Medicine's website as a health economics resource.
The published articles summarized in the Registry undergo a formalized review protocol. These articles address a variety of diseases and treatments and all measure health effects in terms of the QALYs, a standard measure that accounts for quality of life (morbidity) and longevity (mortality
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...
). The CEA Registry team searches MEDLINE
MEDLINE
MEDLINE is a bibliographic database of life sciences and biomedical information. It includes bibliographic information for articles from academic journals covering medicine, nursing, pharmacy, dentistry, veterinary medicine, and health care...
for English-language articles using keywords "QALYs", "quality-adjusted", and "cost-utility analysis". Abstracts from these articles are screened to determine if the paper contains an original cost-utility estimate. The team excludes review, editorial, or methodological articles, as well as cost-effectiveness analyses that do not use QALYs to quantify health benefits.
Each article meeting these criteria is assigned a disease classification by a clinician. Two readers with training in decision analysis
Decision analysis
Decision analysis is the discipline comprising the philosophy, theory, methodology, and professional practice necessary to address important decisions in a formal manner...
and cost-effectiveness analysis independently review each article and record information using a standardized set of forms and instructions. The two readers convene for a consensus audit to resolve any potential discrepancies. On occasion, a third reader may be called upon to help settle disputed items.
Data on over 40 variables is collected for each article.
Article Information
The registry reports:- the type of intervention evaluated
- the country of the analysis
- the funding source.
For methodology, the registry reports
- whether the article correctly calculated incremental cost-utility ratios
- the analytic time horizon and analytic perspective (e.g., societal or health care payer)
- what discount rate, if any was used
- the currency used
- whether the analysis accounted for additional costs associated with greater longevity achieved through treatment
- the type of sensitivitySensitivity analysisSensitivity analysis is the study of how the variation in the output of a statistical model can be attributed to different variations in the inputs of the model. Put another way, it is a technique for systematically changing variables in a model to determine the effects of such changes.In any...
or uncertainty analysisUncertainty analysisCalibrated parameter does not necessarily represents reality, as reality is much more complex. Any any prediction has its own complexities of reality that cannot be represented uniquely in the calibrated model; tehrefore, there is a potential error. Such error must be accounted for when making...
used - whether the article specified a threshold for identifying acceptably favorable cost-effectiveness ratios
- a subjective assessment regarding of the article’s overall quality on an interval scale from 1 (low) to 7 (high).
Ratio Information
The registry describes the health intervention that is the subject of the analysis, and comparator intervention to which it is compared, and the population that is eligible for the intervention. When available, the costs and health benefits (QALYs) associated with both the target and comparator interventions are reported. The registry reports the value of the ratio reported in the original article, as well as the value calculated directly from the cost and health benefit information in the article. The registry also reports the ratio quadrant.| less effective | more effective | |
|---|---|---|
| more costly | 1 | 2 |
| less costly | 3 | 4 |