Question

Given:

Treatment E: Cost = $5,000, benefit = survival rate of 60%

Treatment F: Cost = $7,000, benefit = survival rate of 50%

Treatment G: Cost = $4,000, benefit = survival rate of 40%

Treatment H: Cost =$5,000, benefit = survival rate of 30%

Treatment K: Cost =$3,000, benefit = survival rate of 55%

Treatment J: Cost = $6,000, benefit = survival rate of 68%

1.

What are the ICERS of

K to E?

K to J?

$272.73; $23,076.92

$40,000; $4,000

$23,076.92; $40,000

$4,000; $23,076.92

$40,000; $23,076.92

2.

From K which treatment do we choose next?

E

J

H

G

none of the above

Answer 1

The ICER (incremental cost-effectiveness ratio) is used to measure the cost-effectiveness of different treatment plans. i.e the incremental cost per additional unit of measured effect ( here the probability of survival) .

ICER of K to E = (C_E -C_k ) / (E_E -E_k ) = (5000-3000)/(0.60-0.55) = 2000/0.05 = 40000

ICER of K to J = (C_J-C_k ) / (E_J-E_k ) = ( 6000-3000)/ ( 0.68-0.55) = 3000/0 .13 = 23076.92

1. $40000 $23076.92

ICER of K to G = (C_G-C_k ) / (E_G-E_k ) = 1000/(0.4-.0.55)= - (1000/ .15)

We will not consider the treatment from K to G because the incremental cost is positive and the incremental effect is not. No one wants to pay more for a treatment which would reduce his chance of survival thereafter.

ICER of K to H = (C_H-C_k ) / (E_H-E_k ) = 2000/(0.30-0.55) = - ( 2000/ 0.25)

We will not consider the treatment from K to H for the same reason as mentioned above.

However, to know which treatment group to choose from K we must have a threshold value. We could consider both E and J if both of their ICERs lie below it and under no circumstances, H and G should be considered.

2. Hence the answer to this question is none of the above since no information is given about the threshold value.