Gastromycin is a potent stimulator of gastric motility. Recent studies have shown the use of IV Gastromycin before endoscopy for gastrointestinal (GI) bleeding ulcers helps clear the stomach of blood. You are asked to compare the use of IV Gastromycin to usual care (no pre-op Gastromycin) before GI endoscopy for bleeding peptic ulcers. The perspective is that of the payer, and the time frame is 1 year. Assume patients have a 1.0 QALY if not for the need of ulcer surgery QALYs for the minor surgery and 2-day stay are decreased by 0.10 = 0.90 QALY QALYs for the major surgery and 3-day stay are decreased by 0.20 = 0.80 QALY OPTION AUsual care: Following usual surgery procedures, 70% of the time, the ulcer is located on first-look; there is no second-look endoscopy needed; minor, tuncomplicated surgery is conducted; and a 2-day hospital stay resultsat a cost of $4,000 ($2,000 for surgery; $1,000 per day in hospital times 2 days). The other 30% of the time, a second-look endoscopy is needed due to excessive bleeding; the surgery is more complicated, and a 3-day hospital stay resultsat a cost of $6,000 ($3,000 for surgery and $1,000 per day in hospital times 3 days). For each patient, the average cost would be $4,600 [(0.7 $4,000) + (0.3 $6,000)]. For each patient, the average QALY would be 0.87 [(0.7 0.9 QALY) + (0.3 0.8 QALY)]. OPTION BIV Gastromycin added presurgery: The use of IV Gastromycin adds $500 to the cost of surgery is above the cost of the usual procedures. When using IV Gastromycin, 80% of the time, the ulcer is located on first-look; there is no second-look endoscopy needed; minor, uncomplicated surgery is conducted; and a 2-day hospital stay results ($4,500). The other 20% of the time, a second-look endoscopy is needed due to excessive bleeding, the surgery is more complicated, and a 3-day hospital stay results ($6,500). For each patient, the average cost would be $4,900 [(0.8 $4,500) + (0.2 $6,500)]. For each patient, the average QALY would be 0.88 [(0.8 0.9 QALY) + (0.2 0.8 QALY)]. If a threshold of $20,000 is used as the value of a QALY, do calculations indicate that IV Gastromycin is a cost-effective option? Group of answer choices

No

Yes