Authorities at the British National Health Service (NHS) are determining the app
ID: 1167786 • Letter: A
Question
Authorities at the British National Health Service (NHS) are determining the appropriate treatment to provide elderly males diagnosed with prostrate cancer. The goal of the NHS is to maximize the health benefits they produce under their fixed budget. The per-patient cost and expected health benefit (in QALYs) associated with seven mutually exclusive treatment options are presented in the following table.
Treatment
Cost ($1000s)
QALYs
A
0
0
B
5
0.5
C
40
1.5
D
80
1.9
E
85
2
F
130
2.6
G
220
3.2
a)Identify the dominated treatment option(s).
b)For the non-dominated options, calculate the incremental cost-effectiveness ratio (ICER).
c)Given its limited budget, the British NHS determines it is willing to spend up to $60,000 to produce an additional QALY. Which treatment should it choose?
d)Could treatment F ever be a rational choice for the British NHS? Explain.
Treatment
Cost ($1000s)
QALYs
A
0
0
B
5
0.5
C
40
1.5
D
80
1.9
E
85
2
F
130
2.6
G
220
3.2
Explanation / Answer
Solution ;
a) The dominated treatment option is G with a QALY's of 3.2
b)
c) Given its limited budget, the British NHS can choose treatment B & C . Both these treatment will add up to $ 45,000 per life year saved and NHS is willing to spend upto $ 60,000 to produce an additional QALY. Hence NHS can choose both these treatments .
d) Treatment F can never be a rational choice for the British NHS because it will cost $ 75,000 per life year saved and the NHS budget is just only upto $ 60,000 . Treatment F exceeds NHS budget .
Treatment Cost QALY's ICER A 0 0 B 5 0.5 10 C 40 1.5 35 D 80 1.9 100 E 85 2 50 F 130 2.6 75 G 220 3.2 150Related Questions
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