Evaluating the cost-effectiveness of population health interventions alongside literature reviews: the case of comprehensive geriatric assessment

Apostolos Tsiachristas, Mike Gardner, Graham Ellis, Sasha Shepperd
2017 International Journal of Integrated Care  
Tsiachristas, A et al 2017 Evaluating the cost-effectiveness of population health interventions alongside literature reviews: the case of comprehensive geriatric assessment. International Journal of Integrated Care, 17(5): A489, pp. 1-8, DOI: dx.doi.org/10.5334/ijic.3809 CONFERENCE ABSTRACT Evaluating the cost-effectiveness of population health interventions alongside literature reviews: the case of comprehensive geriatric assessment 17 th International Conference on Integrated Care, Dublin,
more » ... ed Care, Dublin, 08-10 May 2017 Apostolos Tsiachristas 2 Tsiachristas; Evaluating the cost-effectiveness of population health interventions alongside literature reviews: the case of comprehensive geriatric assessment Results: The review of twenty nine trials recruiting 13,766 participants across nine countries found that patients who received CGA were more likely to be alive and in their own homes at follow-up. This is similar to the results from the economic evaluation that showed that CGA was more effective with respect to all three health outcome measurements (0.012 more QALYs, 0.037 more LYs, and 0.019 LYLAHs per patient). The health care costs per patient in the CGA group were £234 (95% CI -£144 to £605) higher than in usual care group. The ICER in terms of QALYs was £19,802, which is close to the £20,000 threshold that NICE suggests as a ceiling value for a QALY; the cost for a LY gained was £6,305 and for a LYLAH gained was £12,568. The probability of CGA to be cost-effective at a £20,000 ceiling ratio for a QALY, LY and LYLAH was 0.50, 0.89, and 0.47 respectively. Conclusions: The methodological approach used in this study provides decision-makers with economic evidence about CGA and could be used to evaluate any other health intervention. CGA is likely to be cost-effective at the NICE cut-off value of £20,000 for a QALY but the uncertainty is high. Limitations: The analysis did not include costs after patient discharge. Future research: Further work is required to establish the optimum way of combining reviewbased results with model-based economic evaluations.
doi:10.5334/ijic.3809 fatcat:4xhw3ckoubctnh3sjhvzr2rrnu