I guess if you take a "societal" (read government or HMO) perspective it does, especially if you believe that an additional yearl of disease free life for a women 21-26 is only worth $100K, which is an arbitrary numbe developed in 1985 that reflects a "societal perspective" on the cut off or rationing point...
"We adopted a societal perspective, discounted costs and benefits by 3% annually, and expressed benefits as quality-adjusted life-years (QALYs) gained. After eliminating strategies that were more costly and less effective or less costly and less cost-effective than an alternative strategy, incremental cost-effectiveness ratios were calculated as the additional cost divided by the additional health benefit associated with one strategy as compared with the next-less-costly strategy. Although there is no consensus on a cutoff point for good value for resources, we interpreted our results in terms of a commonly cited threshold of $50,000 per QALY gained, as well as an upper-bound threshold of $100,000 per QALY gained."
Hmm, and what does that cover...
"The routine vaccination of 12-year-old girls, in the context of current screening and assuming lifelong vaccine-induced immunity, had an incremental cost-effectiveness ratio of $43,600 per QALY gained, as compared with screening alone (Table 2). The addition of a 5-year catch-up program for girls between the ages of 13 and 18 years cost $97,300 per QALY, and extension to 21 years of age cost $120,400 per QALY. The extension of the catch-up program to 26 years of age cost $152,700 per QALY, as compared with the catch-up program to 21 years of age."
The extra $52 K is really society saying, we have decided after $100K we will roll the dice and see if we have to pay for all the costs relateded to screening, treatting, etc. cevical cancer. It does not even address what a 26 year old woman might think a catch up shot is worth....
Oh, and the additional benefits. like avoiding screening and the worry or other illnesses were never counted either.
"when the potential benefits associated with preventing noncervical HPV-16–related and HPV-18–related cancers and HPV-6–related and HPV-11–related juvenile-onset recurrent respiratory papillomatosis were included, cost-effectiveness ratios were reduced"
So of course the NEJM runs an editorial claiming the vaccine is not cost effective, it's press department hypes that and not the guts of the study and the rest of the media takes the lead and will ikely cite (via misrepresentation) the study as proof that many new products are not worth their cost. .
Still believe cost-effectiveness will certainily be a patient-centered and objective process taking into account all stakeholder concerns.
http://content.nejm.org/cgi/content/full/359/8/821
"We adopted a societal perspective, discounted costs and benefits by 3% annually, and expressed benefits as quality-adjusted life-years (QALYs) gained. After eliminating strategies that were more costly and less effective or less costly and less cost-effective than an alternative strategy, incremental cost-effectiveness ratios were calculated as the additional cost divided by the additional health benefit associated with one strategy as compared with the next-less-costly strategy. Although there is no consensus on a cutoff point for good value for resources, we interpreted our results in terms of a commonly cited threshold of $50,000 per QALY gained, as well as an upper-bound threshold of $100,000 per QALY gained."
Hmm, and what does that cover...
"The routine vaccination of 12-year-old girls, in the context of current screening and assuming lifelong vaccine-induced immunity, had an incremental cost-effectiveness ratio of $43,600 per QALY gained, as compared with screening alone (Table 2). The addition of a 5-year catch-up program for girls between the ages of 13 and 18 years cost $97,300 per QALY, and extension to 21 years of age cost $120,400 per QALY. The extension of the catch-up program to 26 years of age cost $152,700 per QALY, as compared with the catch-up program to 21 years of age."
The extra $52 K is really society saying, we have decided after $100K we will roll the dice and see if we have to pay for all the costs relateded to screening, treatting, etc. cevical cancer. It does not even address what a 26 year old woman might think a catch up shot is worth....
Oh, and the additional benefits. like avoiding screening and the worry or other illnesses were never counted either.
"when the potential benefits associated with preventing noncervical HPV-16–related and HPV-18–related cancers and HPV-6–related and HPV-11–related juvenile-onset recurrent respiratory papillomatosis were included, cost-effectiveness ratios were reduced"
So of course the NEJM runs an editorial claiming the vaccine is not cost effective, it's press department hypes that and not the guts of the study and the rest of the media takes the lead and will ikely cite (via misrepresentation) the study as proof that many new products are not worth their cost. .
Still believe cost-effectiveness will certainily be a patient-centered and objective process taking into account all stakeholder concerns.
http://content.nejm.org/cgi/content/full/359/8/821
