A comprehensive league table of cost-utility ratios and a sub-table of "panel-worthy" studies.
OBJECTIVE
The authors compiled a comprehensive league table of cost/QALY ratios, and a standardized table of analyses satisfying selected Reference Case criteria from the USPHS Panel on Cost-Effectiveness in Health and Medicine.


METHODS
They identified 228 cost-utility analyses (CUAs) through literature searches, and abstracted data on methods and cost-utility ratios. The subset of "Panel-worthy" analyses used: a societal or broad health-care perspective, community or patient preference weights, net costs, incremental comparisons, and discounting of costs and QALYs.


RESULTS
The 228 CUAs included ratios for 647 interventions, ranging from cost-saving to $52,000,000/QALY (median = $12,000/QALY). The standardized table presents 112 ratios that met the "Panel-worthy" criteria, with articles published in recent years more likely to meet all of the criteria.


CONCLUSIONS
The comprehensive league table (available on the Web) provides a useful reference, but ratios may not be comparable because of methodologic variations. The standardized table focuses on studies meeting basic methodologic criteria, potentially allowing for better comparison with future Reference Case analyses. Future studies should investigate the quality of analyses' underlying assumptions in addition to whether certain key procedural protocols were met.
Chapman
R H
RH
Program on the Economic Evaluation of Medical Technology, Harvard Center for Risk Analysis, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
Stone
P W
PW
Sandberg
E A
EA
Bell
C
C
Neumann
P J
PJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003625:Data Collection; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D020407:Internet; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019057:Quality-Adjusted Life Years