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

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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.
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
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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].
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].
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
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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].
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].
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 with 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. In addition, 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
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