Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-18T23:33:55.776Z Has data issue: false hasContentIssue false

5 - Economic evaluation of hypothermic neural rescue

from Section 1 - Scientific background

Published online by Cambridge University Press:  05 March 2013

A. David Edwards
Affiliation:
Institute of Reproductive and Developmental Biology, Imperial College, London
Denis V. Azzopardi
Affiliation:
Institute of Reproductive and Developmental Biology, Imperial College, London
Alistair J. Gunn
Affiliation:
School of Medical Sciences, University of Auckland
Get access

Summary

Introduction

Health care economic evaluation is the study of how the inputs of health care activities, such as medicine or physician labour, affect output, where output is a measure of health status. The aim of economic evaluation is to inform decision makers as to the best, i.e., most efficient, allocation of scarce health care resources with a view to optimizing value for money. Implicit in these definitions is the idea of choice: health care resources are scarce and choices between interventions or programmes are necessary because not all desired outputs can be achieved given constrained health care budgets. Economic evaluation does not, therefore, investigate an intervention in isolation; it is a comparative exercise that examines the costs and consequences of possible decisions between multiple courses of action.

The focus of this chapter is to review the methods used and evidence informing the economic costs and consequences of hypothermia for neonatal rescue. The chapter will begin by providing an overview of the study designs, economic methods and approaches to incorporating statistical uncertainty that are available when conducting an economic evaluation where the patient group of interest is young children. This will be followed by a summary and critique of published economic evaluations that have examined resource allocation issues surrounding inducing hypothermia in children with encephalopathy. The final section will highlight significant differences between the identified studies and will critically discuss the effects alternative assumptions have on the study conclusions.

Type
Chapter
Information
Neonatal Neural Rescue
A Clinical Guide
, pp. 53 - 64
Publisher: Cambridge University Press
Print publication year: 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Drummond, MF, Obrien, BJ, Stoddart, GL, et al. Methods for the economic evaluation of health care programmes. 3rd edition. Oxford: Oxford University Press; 2005.Google Scholar
Briggs, AH, Gray, AM. Power and sample size calculations for stochastic cost-effectiveness analysis. Med Decis Making 1998;18:S81–92.CrossRefGoogle ScholarPubMed
Sculpher, MJ, Claxton, K, Drummond, M, et al. Whither trial-based economic evaluation for health care decision making?Health Econ 2006;15:677–87.CrossRefGoogle ScholarPubMed
Azzopardi, DV, Strohm, B, Edwards, AD, et al. Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med 2009;361:1349–58.CrossRefGoogle ScholarPubMed
Gluckman, PD, Wyatt, JS, Azzopardi, D, et al. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet 2005;365:663–70.CrossRefGoogle ScholarPubMed
Shankaran, S, Laptook, AR, Ehrenkranz, RA, et al. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med 2005;353:1574–84.CrossRefGoogle ScholarPubMed
Briggs, AH, O’Brien, BJ. The death of cost-minimization analysis?Health Econ 2001;10:179–84.CrossRefGoogle ScholarPubMed
Petrou, S, Bischof, M, Bennett, C, et al. Cost-effectiveness of neonatal extracorporeal membrane oxygenation based on 7-year results from the United Kingdom Collaborative ECMO Trial. Pediatrics 2006;117:1640–9.CrossRefGoogle ScholarPubMed
Gold, MR, Siefel, JE, Russel, LB, et al. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.Google Scholar
Von Neumann, J, Morgenstern, OTheory of games and economic behavior. 3rd edition. New York: Wiley; 1953.Google Scholar
Torrance, GW, Thomas, WH, Sackett, DL. A utility maximization model for evaluation of health care programs. Health Serv Res 1972;7:118–33.Google ScholarPubMed
Sung, L, Young, NL, Greenberg, ML, et al. Health-related quality of life (HRQL) scores reported from parents and their children with chronic illness differed depending on utility elicitation method. J Clin Epidemiol 2004;57:1161–6.CrossRefGoogle ScholarPubMed
Saigal, S, Stoskopf, BL, Burrows, E, et al. Stability of maternal preferences for pediatric health states in the perinatal period and 1 year later. Arch Pediatr Adolesc Med 2003;157:261–9.CrossRefGoogle ScholarPubMed
Sung, L, Greenberg, ML, Young, NL, et al. Validity of a modified standard gamble elicited from parents of a hospital-based cohort of children. J Clin Epidemiol 2003;56:848–55.CrossRefGoogle ScholarPubMed
EuroQol – a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy 1990;16:199–208.Google Scholar
Torrance, GW, Furlong, W, Feeny, D, et al. Multi-attribute preference functions. Health Utilities Index. Pharmacoeconomics 1995;7:503–20.CrossRefGoogle ScholarPubMed
Sung, L, Petrou, S, Ungar, WMeasuring health utilities in children and their parents. In: Ungar, W, editor. Economic evaluation in child health. Oxford: Oxford University Press; 2009:77–90.CrossRefGoogle Scholar
Oostenbrink, R, AM, HA, Essink-Bot, ML. The EQ-5D and the Health Utilities Index for permanent sequelae after meningitis: a head-to-head comparison. J Clin Epidemiol 2002;55:791–9.CrossRefGoogle ScholarPubMed
Feeny, D, Juniper, EF, Ferrie, PJ, et al. Why not just ask the kids? Health-related quality of life in children with asthma. In: Drotar, D, editor. Measuring health-related quality of life in children and adolescents. London: Lawrence Erlbaum Associates; 1998.Google Scholar
Donaldson, C, Shackley, P, Abdalla, M, et al. Willingness to pay for antenatal carrier screening for cystic fibrosis. Health Econ 1995;4:439–52.CrossRefGoogle ScholarPubMed
Ryan, M, Diack, J, Watson, V, et al. Rapid prenatal diagnostic testing for Down syndrome only or longer wait for full karyotype: the views of pregnant women. Prenat Diagn 2005;25:1206–11.CrossRefGoogle ScholarPubMed
Regier, DA, Ryan, M, Phimister, E, et al. Bayesian and classical estimation of mixed logit: An application to genetic testing. J Health Econ 2009;28:598–610.CrossRefGoogle ScholarPubMed
Regier, DA, Friedman, JM, Marra, CA. Value for money? Array genomic hybridization for diagnostic testing for genetic causes of intellectual disability. Am J Hum Genet 2010;86:765–72.CrossRefGoogle ScholarPubMed
Briggs, AH, Wonderling, DE, Mooney, CZ. Pulling cost-effectiveness analysis up by its bootstraps: a non-parametric approach to confidence interval estimation. Health Econ 1997;6:327–40.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Briggs, AH, Claxton, K, Schulpher, MDecision modelling for health economic evaluation. Oxford: Oxford University Press; 2006.Google Scholar
Black, WC. The CE plane: a graphic representation of cost-effectiveness. Med Decis Making 1990;10:212–4.CrossRefGoogle ScholarPubMed
van Hout, BA, Al, MJ, Gordon, GS, et al. Costs, effects and C/E-ratios alongside a clinical trial. Health Econ 1994;3:309–19.CrossRefGoogle Scholar
National Institute for Clinical Excellence (NICE). Guide to the methods of technology appraisal. London: Nice; 2008.Google Scholar
Laupacis, A, Feeny, D, Detsky, AS, et al. How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. CMAJ 1992;146:473–81.Google ScholarPubMed
Gray, J, Geva, A, Zheng, Z, et al. CoolSim: using industrial modeling techniques to examine the impact of selective head cooling in a model of perinatal regionalization. Pediatrics 2008;121:28–36.CrossRefGoogle Scholar
Regier, DA, Petrou, S, Henderson, J, et al. Cost-effectiveness of therapeutic hypothermia to treat neonatal encephalopathy. Value Health 2010;13:695–702.CrossRefGoogle ScholarPubMed
Horn, A, Thompson, C, Woods, D, et al. Induced hypothermia for infants with hypoxic-ischemic encephalopathy using a servo-controlled fan: an exploratory pilot study. Pediatrics 2009;123:e1090–8.CrossRefGoogle ScholarPubMed
Stark, AR. Levels of neonatal care. Pediatrics 2004;114:1341–7.Google ScholarPubMed
Mangham, LJ, Petrou, S, Doyle, LW, et al. The cost of preterm birth throughout childhood in England and Wales. Pediatrics 2009;123:e312–27.CrossRefGoogle ScholarPubMed
Zupancic, JAF. A systematic review of costs associated with preterm birth. In: Behrman, R, Sith-Butler, A, editors. Preterm birth: causes, consequences and prevention. Washington, DC: National Academic Press; 2006.Google Scholar
Akisu, M, Huseyinov, A, Yalaz, M, et al. Selective head cooling with hypothermia suppresses the generation of platelet-activating factor in cerebrospinal fluid of newborn infants with perinatal asphyxia. Prostaglandins Leukot Essent Fatty Acids 2003;69:45–50.CrossRefGoogle ScholarPubMed
Battin, MR, Penrice, J, Gunn, TR, et al. Treatment of term infants with head cooling and mild systemic hypothermia (35.0 degrees C and 34.5 degrees C) after perinatal asphyxia. Pediatrics 2003;111:244–51.CrossRefGoogle Scholar
Centers for Disease Control and Prevention. Economic costs associated with mental retardation, cerebral palsy, hearing loss and vision impairment: United States. MMWR Morb Mortal Wkly Rep 2004;53:57–9.Google Scholar
Report of working group of the British Association of Perinatal Medicine and Neonatal Nurses Association on categories of babies requiring neonatal care. Arch Dis Child 1992;67:868–9.CrossRef
Department of Health. NHS reference costs 2006–2007. London: Department of Health; 2008.Google Scholar
BNF 56. British Medical Association and Royal Pharmaceutical Society of Great Britain; 2008.
Feeny, D, Furlong, W, Torrance, GW, et al. Multi-attribute and single-attribute utility functions for the health utilities index mark 3 system. Med Care 2002;40:113–28.CrossRefGoogle Scholar
Edwards, AD, Brocklehurst, P, Gunn, AJ, et al. Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: synthesis and meta-analysis of trial data. BMJ 2010;340:c363.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×