title: The use of cost per life year gained as a measurement of cost-effectiveness in Spain: a systematic review of recent publications.
abstract: OBJECTIVE
  The objective of this study was to evaluate the methodological characteristics of cost-effectiveness evaluations carried out in Spain, since 1990, which include LYG as an outcome to measure the incremental cost-effectiveness ratio.
  
  
  METHODS
  A systematic review of published studies was conducted describing their characteristics and methodological quality. We analyse the cost per LYG results in relation with a commonly accepted Spanish cost-effectiveness threshold and the possible relation with the cost per quality adjusted life year (QALY) gained when they both were calculated for the same economic evaluation.
  
  
  RESULTS
  A total of 62 economic evaluations fulfilled the selection criteria, 24 of them including the cost per QALY gained result as well. The methodological quality of the studies was good (55%) or very good (26%). A total of 124 cost per LYG results were obtained with a mean ratio of 49,529<euro> and a median of 11,490<euro> (standard deviation of 183,080). Since 2003, a commonly accepted Spanish threshold has been referenced by 66% of studies. A significant correlation was found between the cost per LYG and cost per QALY gained results (0.89 Spearman-Rho, 0.91 Pearson).
  
  
  CONCLUSIONS
  There is an increasing interest for economic health care evaluations in Spain, and the quality of the studies is also improving. Although a commonly accepted threshold exists, further information is needed for decision-making as well as to identify the relationship between the costs per LYG and per QALY gained.
authors.affiliation: Medtronic Iberica, Madrid, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Rodríguez Barrios
authors.forename: Ferran
authors.initials: F
authors.lastname: Pérez Alcántara
authors.forename: Carlos
authors.initials: C
authors.lastname: Crespo Palomo
authors.forename: Paloma
authors.initials: P
authors.lastname: González García
authors.forename: Enrique
authors.initials: E
authors.lastname: Antón De Las Heras
authors.forename: Max
authors.initials: M
authors.lastname: Brosa Riestra
mesh_terms: D020811:Biomedical Technology / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000379:methods / Q000706:statistics & numerical data; D019057:Quality-Adjusted Life Years; D013030:Spain