Case Study - CEA

NoneIntroduction and Learning Objectives

By the end of this session, participants will be able to:

  1. Calculate incremental costs and effectiveness
  2. Apply dominance rules to eliminate both dominated and extendedly dominated strategies
  3. Calculate ICERs
  4. Apply WTP thresholds to make policy decisions

Now that we have a model, we need to understand how the strategies compare to each other.

NoneWhy are we doing this?

In cost-effectiveness analysis, having costs and outcomes is helpful but can be difficult to understand how much difference exists between each strategy. The Incremental Cost-Effectiveness Analysis allows us to understand how these strategies compare to each other taking both cost and quality of life into consideration.

NoneYour Task

Hand calculate an Incremental Cost-Effectiveness Analysis using a WTP = $100,000/Life Year gained [NOTE THIS IS A COUNT SPECIFIC WTP THRESHOLD]

In the last exercise you should have gotten:

Cost and Life Year Outcomes for Cancer strategies ## Perform a cost-effectiveness analysis of the treatment options using LYs as the measure of health effects.
Discounted Cost Discounted Life Years
No Screen/Treat 2,800 19.04
Treat all 30,000 19.484
Screen all 4,950 19.68

Which strategy would you choose and why, if the willingness-to-pay threshold is $100,000 per life year gained?

Treatment Options
Strategy Discounted Costs Discounted LYs Incremental Costs Incremental LYs ICER ($/LY)
ICER Calculation Table 1
Strategy Discounted Costs Discounted LYs Incremental Costs Incremental LYs ICER ($/LY)
ICER Calculation Table 2
Strategy Discounted Costs Discounted LYs Incremental Costs Incremental LYs ICER ($/LY)

Verify your results in Amua

Update the properties in Amua to have the model run a cost-effectiveness analysis with LY as the effect.

Note: The basecase is No Screen/Treat

More assistance with step

  1. Go to Model > Properties > Analysis

  1. Under “Analysis Type” choose “Cost-Effectiveness Analysis (CEA)”

  1. Set the settings to the following:

TipCheck your answer


Enter the ICER of the strategy you would choose (to two decimal places)


Additional Strategies

Another member of the lab has built a model that looks at screening by risk. They were able to provide you the Cost and Life years for two strategies. Include these in your CEA to determine which of the 5 total strategies is the most cost-effective.

Discounted Cost Discounted LYs
Screen High Risk Only $28,000 19.89
Treat High Risk Only $29,000 19.91

Add in those two strategies to your incremental calculations

NoneWhy are we doing this?

Hand calculating the Incremental CEA will help you understand the logic behind the calculations that Amua is completing. This will also help you build intuition on if the results seem accurate to what you would expect.

NoneYour Task

Hand calculate an Incremental Cost-Effectiveness Analysis using a WTP = $100,000/Life Year gained with the additional strategies included

Which strategy would you choose and why, if the willingness-to-pay threshold is $100,000 per life year gained?

Treatment Options
Strategy Discounted Costs Discounted LYs Incremental Costs Incremental LYs ICER ($/LY)
ICER Calculation Table 1
Strategy Discounted Costs Discounted LYs Incremental Costs Incremental LYs ICER ($/LY)
ICER Calculation Table 2
Strategy Discounted Costs Discounted LYs Incremental Costs Incremental LYs ICER ($/LY)
TipCheck your answer

What is the ICER of the strategy you would choose? (to 2 decimal places)

Enter your result:

TipCheck your answer

What is the ICER of the strategy you would choose if the WTP was $200,000/LY? (to 2 decimal places)

Enter your result:

Answer Key