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1. Suppose that you are asked to conduct a CEA of an experimental treatment for

ID: 1128218 • Letter: 1

Question

1. Suppose that you are asked to conduct a CEA of an experimental treatment for Zika:

Without treatment, the average patient’s life-expectancy is 0.5 QALYs. With treatment, the average patient’s life-expectancy is 25 QALYs. The current cost of the treatment is $50,000.

Calculate and show on a graph the ICER.

b) There are actually different companies working on a similar treatment, with prices ranging from $30,000 to $60,000. Modify your graph from part a) to incorporate this uncertainty, using these results as the lower- and upper-bound estimates (best case/ worst case) of cost.

c) Suppose there is also uncertainty about quality-adjusted life expectancy:

With treatment, life expectancy might be as low as 2.5 QALYs or as high as 30 QALYs.

d) Modify your graph from part b to incorporate the uncertainty in costs from part b and the uncertainty in effects from part c. [Hint: this is a rectangular area, not a confidence ellipsoid.]

Explanation / Answer

a. ICER = 50,000 * 0.5 = $25,000

50,000 * 25 = $125,0000.

So, ICER = $125,0000 - $25,000/25-0.5

= $1225,000/24.5

= $50,000/QALY

b. ICER = $60,000-$30,000/25-0.5

= $30000/24.5

= $1224.49/QALY.

c. ICER = $60,000-$30,000/30-2.5

= $30,000/27.5

= $1090.90/ QALY.