2.Cost Effectiveness Analysis

The Australian government Department of Health and the Department of Transport have decided that the number of injuries and lives lost due to motor vehicle accidents is of national importance. After much deliberation they have decided to pilot two alternative programmes against a control group in three regions of Victoria. They want to include a cost effectiveness analysis of the interventions.

The interventions are:

1.Mandatory driver education sessions for all people aged 18 years each year for three years. Education to include general driver education as well as the risks associated with using a mobile phone while driving.

2.The above driver education sessions over three years as well as the provision of a mobile phone blocking device for cars in the first year.

3."Do nothing".

The research question you have been asked to evaluate for your cost effectiveness analysis is:

From a societal perspective which of the three interventions is the most cost effective per life year saved over a three year period?

The study is to be implemented as follows:

10000 people will receive the education alone intervention in the Barwon south western region 10000 people will receive the education plus phone blocking device in the Gippsland region 10000 people will be the control group in the Hume region

Question 1

Identify the relevant outcomes we might expect to see as a result of the interventions. Which indicators will you use to measure your outcomes for a cost effectiveness analysis?

Which outcomes are more relevant from:

i). the Department of Health's perspective? ii). the Department of transports perspective? iii). a societal perspective?

Question 2

If the primary outcome measure that is of most interest is lives saved, how will you collect the data?

Question 3

Your results show the annual incidence of motor vehicle accidents as follows:

Education alone 15%

Education + device 10%

Do nothing 20%

The mortality rate associated with motor vehicle accidents is 20%

Complete the following population table (rounding the numbers to zero decimal point):

Complete the following population table (rounding the numbers to zero decimal point): No intervention No. Alive No. in accident No. Dead No. alive Year 1 10,000 Year 2 9,600 1,920 384 9,216 Year 3 1,843 8,847 Education No. Alive No. in accident No. Dead No. alive Year 1 10,000 300 9,700 Year 2 1,455 291 Year 3 9,409 1,411 282 9,127 873 Education + device No. Alive No. in accident No. Dead No. alive Year 1 10,000 Year 2 9,800 980 9,504 Year 3 9,604 960 192 9,412 588 28,816 The following is the cost data you have obtained: Average cost of injurvr (alive) $20,000 Average cost of injuryr [dead] 55,000 Cost ofeducation (per person per year] $1,000 Cost of device $2,000 Complete the cost tables below {no discounting is applied in this exercise): Year 1 costs Injuryalive Injurydead Education (Si Device (S) total DO nothing 32,0GU,OGD.UU 34,000,000.0U Education alone 1,500,000.00 10,000,00000 Education + device 10,000,00000 47,000,00000 Year 2 costs Injuryalive Injurydead Education (5) Device (S) total Do nothing Education alone 23,280,00000 1,455,000.00 Education + device 980,000.00 9,800,000.00 Year 3 costs Injurvealive Injurvedead Education (S) Device (S) total Do nothing 29,480,00000 Education alone 1,410,000.00 33,399,00000 Education + device 15,360,00000 9,604,000.00 Complete the following summary table: Intervention Total Costs (3 years) Total Deaths Total Alive (3 years) (3 years Do nothing 1,153 Education alone $ 103,334,000 Education + device Determine the Incremental Cost per Life Saved (show the actual calculation in this table) Intervention Incremental cost/ Life saved Education alone Versus do nothing Education + device Versus do nothing Education alone Versus Education + device Cost differences Lives saved ICER Education vs 280 Do nothing Education + device $ 2,512 vs Do nothing Education vs $ 3,950,000 Education + device