Economics of Using Biocidal Surfaces - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 168

Table 8.1 Report from the Second American Thoracic Society Workshop on outcome research

Numerator
(costs)

Denominator (outcome or
benefit) Type of study Examples Comment

Cost
minimization

Dollars None Antibiotic therapy for ICU patients at low risk

of nosocomial pneumonia

No estimate of consequences on other health
care costs. Clinical outcomes are
assumed to be equivalent (i.e., no difference
in subsequent pneumonia rate or mortality)
even though formal equivalence study not
conducted

Drug acquisition costs for a 3-d course
of ciprofloxin are $9,520 less
expensive than average acquisition
costs for unregulated antibiotic
prescription

Cost benefit Dollars Dollars Use of an aminoglycoside dose-monitoring

program for burn patients with
gram-negative sepsis

A key advantage is that all costs and effects are
expressed in monetary units (dollars),
facilitating assessment of worth. However,
the key concern is that converting clinical
effects, such as lives lost (or gained), into
dollar amounts is controversial, somewhat
arbitrary, and biased toward saving the lives
of those with greater earning capacity

The dose-monitoring program led
to $8.70 savings per dollar spent

Cost-
effectiveness

Dollars Specific Measure of

effectiveness (lives
saved)

Thrombolysis for acute myocardial
infarction

Assesses change in both costs and effects but
avoids controversy of converting clinical
outcomes into dollar values. It is not clear
whether “lives saved” are equivalent to other
lives saved by other therapies in other
diseases

Tissue plasminogen activator costs an
additional $32,678 per additional life
saved when compared with streptokinase

Cost utility Dollars A common utility metric

(quality-adjusted life -
years)

Prophylaxis against recurrence of peptic
esophageal strictures

Cost per QALY allows comparison with
other therapies used in other diseases.
This is now the recommended approach

Omeprazole costs an additional $49,600
per additional QALY when compared
with ranitidine