Open AccessComparing the cost-per-QALYs gained and cost-per-DALYs averted literatures
Author(s) -
Peter J. Neumann,
J. Edgar Anderson,
Ari D Panzer,
Elle Pope,
Brittany D’Cruz,
David D. Kim,
Joshua T. Cohen
Publication year - 2018
Publication title -
gates open research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.069
H-Index - 9
ISSN - 2572-4754
DOI - 10.12688/gatesopenres.12786.2
Subject(s) - psychological intervention , disease , quality adjusted life year , cost effectiveness , environmental health , medicine , pathology , risk analysis (engineering) , psychiatry
Background : We examined the similarities and differences between studies using two common metrics used in cost-effectiveness analyses (CEAs): cost per quality-adjusted life year (QALY) gained and cost per disability-adjusted life year (DALY) averted. Methods : We used the Tufts Medical Center CEA Registry, which contains English-language cost-per-QALY gained studies, and the Global Cost-Effectiveness Analysis (GHCEA) Registry, which contains cost-per-DALY averted studies. We examined study characteristics, including intervention type, sponsor, country, and primary disease, and also compared the number of published CEAs to disease burden for major diseases and conditions across geographic regions. Results : We identified 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 and observed rapid growth for both literatures. Cost-per-QALY studies most often examined pharmaceuticals and interventions in high-income countries. Cost-per-DALY studies predominantly focused on infectious disease interventions and interventions in low and lower-middle income countries. We found that while diseases imposing a larger burden tend to receive more attention in the cost-effectiveness analysis literature, the number of publications for some diseases and conditions deviates from this pattern, suggesting “under-studied” conditions (e.g., neonatal disorders) and “over-studied” conditions (e.g., HIV and TB). Conclusions : The CEA literature has grown rapidly, with applications to diverse interventions and diseases. The publication of fewer studies than expected for some diseases given their imposed burden suggests funding opportunities for future cost-effectiveness research.