Chronic diseases are the leading cause of disability and death in the U.S., and contribute to rapidly rising health care costs. Chronic disease self-management programs (CDSMP) have been developed to improve quality of health and reduce health care costs. Evidence suggests that such programs can reduce premature death for individuals suffering from chronic conditions.

Suppose a retirement community (minimum age 55) wants to develop a CDSMP for its members and can choose among three programs of different intensity levels: low, medium, high. The cost and effectiveness of the programs increase with intensity.

In answering the questions below, use the following information about the retirement community and the three programs:

1. Community

Number of members potentially participating in the CDSMP: 70

Average remaining life expectancy of each participant: 25 years

2. Programs

Low: Reduces premature death by 3 for every 10,000 participants (i.e. reduced probability of premature death, p = 0.0003)

Cost per participant: $500

Medium: Reduces premature death by 7 for every 10,000 participants (i.e. p=0.0007)

Cost per participant: $800

High: Reduces premature death by 12 for every 10,000 participants (i.e. p=0.0012)

Cost per participant: $1300

A. calculate, for each level of CDSMP intensity, the number of life-years saved among the potential participants in the retirement community

LOW:

MEDIUM:

HIGH:

(PLEASE SHOW CALCULATION)

B. Calculate the cost of each program for the entire group of potential participants in the retirement community.

LOW:

MEDIUM:

HIGH:

(PLEASE SHOW CALCULATION)

C. In the boxes below, calculate the incremental cost-effectiveness ratio (ICER) for each type of CDSMP.

LOW:

MEDIUM:

HIGH:

(PLEASE SHOW CALCULATION)