title: Health care economic analyses and value-based medicine.
abstract: Health care economic analyses are becoming increasingly important in the evaluation of health care interventions, including many within ophthalmology. Encompassed with the realm of health care economic studies are cost-benefit analysis, cost-effectiveness analysis, cost-minimization analysis, and cost-utility analysis. Cost-utility analysis is the most sophisticated form of economic analysis and typically incorporates utility values. Utility values measure the preference for a health state and range from 0.0 (death) to 1.0 (perfect health). When the change in utility measures conferred by a health care intervention is multiplied by the duration of the benefit, the number of quality-adjusted life-years (QALYs) gained from the intervention is ascertained. This methodology incorporates both the improvement in quality of life and/or length of life, or the value, occurring as a result of the intervention. This improvement in value can then be amalgamated with discounted costs to yield expenditures per quality-adjusted life-year ($/QALY) gained. $/QALY gained is a measure that allows a comparison of the patient-perceived value of virtually all health care interventions for the dollars expended. A review of the literature on health care economic analyses, with particular emphasis on cost-utility analysis, is included in the present review. It is anticipated that cost-utility analysis will play a major role in health care within the coming decade.
authors.affiliation: The Center for Value-Based Medicine, Suite 210, 1107 Bethlehem Pike, Flourtown, PA 19031, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Brown
authors.forename: Gary C
authors.initials: GC
authors.lastname: Brown
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.forename: Jennifer
authors.initials: J
authors.lastname: Landy
mesh_terms: D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000191:economics*; D003695:Delivery of Health Care / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D015276:Health Care Rationing / Q000191:economics; D006801:Humans; D008136:Longevity; D018803:Models, Economic; D009885:Ophthalmology / Q000191:economics*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years