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- Johannesson, Magnus
(author)
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Economic evaluation of lipid lowering — A feasibility test of the contingent valuation approach
- 1992
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In: Health policy (Amsterdam). - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 20:3, s. 309-320
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Journal article (peer-reviewed)abstract
- A large number of cost-effectiveness analyses of treatment of high cholesterol levels have been published the last few years. Due to the Inherent problems of cost-effectiveness analysis of prevention and the specific problems in the case of lipid lowering, it is Important to test alternative approaches. This study reports the results of a pilot study of three benefit measures based on individual preferences. Willingness to pay (WTP), willingness to give up leisure time (WTGT) and maximum acceptable risk (MAR) for lowering cholesterol levels to normal were investigated among persons with hypercholesterolaemia in a postal survey. The respondents were on average prepared to pay about SEK 450 per month, to give up about 7 hours of leisure time per week or to take an immediate mortality risk of about 1.4% to get normal lipid levels. The WTP and WTGT questions seemed to be about equally acceptable, whereas the MAR question performed less well with respect to acceptability. It is concluded that especially WTP deserves further attention, due to Its inherent advantages, since it performed at least as well as the other measures.
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- Johannesson, Magnus, et al.
(author)
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Economic evaluation of osteoporosis prevention
- 1993
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In: Health policy. - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 24:2, s. 103-124
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Journal article (peer-reviewed)abstract
- In this paper economic evaluation of osteoporosis prevention is discussed. So far economic evaluation in this area has been limited to cost-effectiveness analysis. Four cost-effectiveness analyses of osteoporosis prevention are reviewed. It is noted that the major problem with these studies is the lack of reliable and valid data to base the cost-effectiveness analyses on, which precludes clear-cut conclusions about the cost-effectiveness of osteoporosis prevention. The studies, however, form a basis for future cost-effectiveness analyses in this field and as new data become available it should be possible to improve the accuracy and precision of the analyses. Due to the methodological problems of cost-effectiveness analysis and the decisionmaker approach to economic evaluation, it is also argued that the contingent valuation (CV) method of measuring willingness to pay should be tested in this area. The CV method can be used both to value an actual treatment and the outcome of that treatment and the resulting amount can be compared with the costs (including the costs of externalities) to carry out cost-benefit analysis. It is concluded that a lot of work remains to be done in this area before economic evaluations can give a real contribution to policy, but such work may well be worthwhile due to the importance of this public health problem.
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- Johannesson, Magnus
(author)
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The cost-effectiveness of the switch towards more expensive antihypertensive drugs
- 1994
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In: Health policy (Amsterdam). - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 28:1, s. 1-13
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Journal article (peer-reviewed)abstract
- A switch from treatment with diuretics and beta-blockers to treatment with the more expensive ACE-inhibitors and calcium-antagonists has been noted in the hypertension field. The aim of this paper was to analyse the cost-effectiveness of this switch towards more expensive antihypertensive drugs in Sweden. The upper limit of the cost-effectiveness of ACE-inhibitors and calcium-antagonists compared with diuretics and beta-blockers was estimated by assuming that ACE-inhibitors and calcium-antagonists achieve the epidemiologically expected risk reduction for coronary heart disease. The incremental cost per life-year gained varies between ∼ SEK 50 000 and ∼ SEK 6 000 000 ($1 = SEK 6) in the different patient groups analysed. It is concluded that ACE-inhibitors and calcium-antagonists may be potentially cost-effective in some patient groups at a high risk of coronary heart disease. Since an improved risk reduction has not been demonstrated in clinical trials, however, ACE-inhibitors and calcium-antagonists cannot at present be recommended for hypertension treatment in any patient groups unless treatment with diuretics and beta-blockers is contraindicated.
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