Changes in Cost-Effectiveness over Time: The Case of Epoetin Alfa for Renal Replacement Therapy Patients in the UK

• Published in: The European journal of health economics Vol. 4; no. 2; pp. 115 - 121
• Main Authors: Remák, E., Hutton, J., Jones, M., Zagari, M.
• Format: Journal Article
• Language: English
• Published: Germany Springer-Verlag 2003; Springer Nature B.V
• Subjects: Administrative expenses; Anemia; Blood transfusion; Case studies; Changes; Cost analysis; Cost benefit ratio; Cost efficiency; Cost estimates; Decision making; Drugs; Economics; Epics; Health economics; Hypertension; Intervention; Marginal cost pricing; Original Papers; Patients; Quality of life; Renal replacement therapy; Studies; Unit costs; Variable costs; United Kingdom > UK
• ISSN: 1618-7598; 1618-7601
• DOI: 10.1007/s10198-002-0164-z

We analysed the factors influencing cost-effectiveness of a health care intervention over time using economic evaluations of erythropoietin as a case study. The analytical framework of a study conducted in 1990 was used to revisit the cost-effectiveness of erythropoietin. Study variables were updated to 2000 using meta-analysis, published sources, and expert opinion. After 10 years of further experience with the use of erythropoietin the cost-effectiveness ratio now falls within the range considered acceptable in the UK. The analysis shows that the vast proportion of the reduction in the cost-effectiveness ratio achieved since 1990 results from reductions in the dose and price of erythropoietin. True cost-effectiveness of a treatment can change over time, and early analysis can reach incorrect conclusions because of data deficiencies. The existence of a body such as NICE might have delayed the widespread adoption of erythropoietin in the UK, but the higher standards of clinical and economic evidence demanded by such a body might have expedited the appropriate pricing, dosage, and hence utilisation of the treatment.