Cost-Utility Analyses: Measures and Differences in Disease Burden Assessments

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Abstract
Cost-utility analyses refer to a technique used to govern the resource distribution processes. This
system of analysis comprises the cost of calculating the quality-adjusted life years as well as the
cost of disability-adjusted life years. Also considered in this assignment is the measurement of
Years of potential life lost or potential years of life lost, thus demonstrating a measure of
premature mortality figuratively. This can assist with public health forecasting, through
calculating the social and economic loss. The purpose of this assignment is to discuss the varying
measures used in CUA and to confer the differences in disease burden assessments found by
using the different measures. Lung cancer, mental illness, and coronary heart disease are the
disease burdens being presented. There are many mitigating factors when considering disease
burdens, and many studies of public health are becoming more defined as health economists can
utilize health indexes which more accurately reflect current public health trends.
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Introduction
Cost-utility analyses (CUA) refers to economic analysis whereby the increasing program costs
from a certain point of view is assessed in comparison to the health improvement analyses which
is expressed using the QALYs units [1]. The cost-utility analysis helps in determining the cost of
utility terms that is in terms of the quantity and the quality. An example would be comparing
different groups of drugs or the procedures whose importance may be differing. Therefore, the
CUA is used in the expression of the money value in terms of health outcome single type [1, 2].
Cost-utility analysis is the most complex type of pharmacy-economic analysis which accounts
for the quality improvement of life and the quantity of life that is granted by the intervention of
expended resources [3]. Benefits of CUA relate directly to ‘perceived values of expected
outcomes and allow measurement of outcome for ‘comparison of costs and outcomes in different
programs. Potentially, this allows for comparison models in health care assessing opportunity
cost so that established models of care may be adopted in the budget, already proven to be cost
effective. Measurements of the outcome can be expressed as units of health portraying quantity
and life quality, with utility being the profits obtained from health and health care [3, 4]. These
are used to provide information to health decision makers so they may be informed and able to
make decisions based on important economic evaluations (Lancsar et al., 2008).
Health consumers are not always able to know or understand expected health results, and
perception of life quality and preferences varies amongst individuals. Measurement techniques
like the EQ-5D (EuroQol) and Health Utilities Index aim to reduce the inconsistency in the way
health states are described and may reduce the disparity in the description of health states [5].
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Disability-Adjusted Life Years (DALY)
DALY is a summarized measure of the health of the population that is the reason for mortality
and nonfatal consequences of health. Disability-Adjusted Life Years (DALY) was initially
developed for the key purpose of quantification of the global burden of disease (GBD). It was
designed as an analysis unit tor relative magnitude measurement of the losses of the health life
affiliated to the different initiators of diseases and injuries [6]. Additionally, DALYs was
intended to become a health benefit metric in the cost-effectiveness of denominator ratios.
Worldwide, DALYs measure morbidity and the mortality. The DALY has been used to quantify
disease. It allows for a combination of the single indicator” years of life lived with disabilities”
and “the years of life from premature death (YLL)”[6, 7].
Quality-Adjusted Life Years (QALY)
The QALY was invented back in the 1970s. It has now become recognized as a standard tool
internationally since the 1990s [8]. Quality-Adjusted Life Years (QALY) refers to a product of
arithmetic expectancy of life which is combined with the measurement of the life quality in
terms of the number of years remaining. The calculations that obtained are relatively
straightforward based on the time a person may likely stay in a specific health state which is
weighted by a score of utility from the standard values that have been invented [9]. The values
equate that at ‘1', the health for someone is perfect, while at ‘0', the person's health is no more.
Due to the state of some health which is characterized by too much difficulty and pain which are
just regarded as equal to death, they are often given a value which is negative [8,9].
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The QALY can combine the health effects of interventions on the morbidity and mortality into a
single index hence providing a common currency to help in comparing many areas of diseases.
With time, there have been varied individual experiences in different states of health. At a point
of weighing states of health based on the scores of utility affiliated with them [10].
Potential Years of Life Lost (PYLL) or Years of Potential Life Lost (YPLL)
PYLL or YPLL refers to the estimate of the year's someone would have been able to live if that
person was had not died a premature death. Therefore, it is a premature mortality measurement.
YPLL or PYLL being a method and a different option to the mortality rates, it offers more
emphasis to deaths that happen to young people. It also considers the impact of both inability and
early death of persons through the use of DALYs. YLL accounts for the age at which the deaths
happen through much consideration of the deaths of younger people and a small weight of the
death of persons who are old. The YLL indicates the measure that the YPLL because of the
proportion of the YPLL lost people is based on premature mortality. YPLL is obtained through
calculation of the number of the deaths then multiplied by the expected life standard at that age
the death of the young person happened [12]. The life expectancy standard that is used for the
Years of life lost at every age is similar for the deaths in every region of the world and similar to
the one used to calculate the DALYs. Also, 3% discounting of time and age non-uniformity
weights which one will give less weight to the year’s that a person lives at a young age or old
age. Based on the non-uniformity age weights and the discounting of 3%, an infancy death in
correspondence is at 33 YPLL and the deaths are at the ages of 5 to 20 or even to around 36
YPLL [11, 12].
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