Valuing health care events and resources and cost-effectiveness analysis:
Cost reporting. Report costs per category (eg, total, hospital, medications) per study participant per 12 months. Unit costs. Costs may be estimated using average unit cost for the type of healthcare visit (eg, cost per visit, cost per hospital stay, cost per medication). The subcommittee strongly recommends using paid amounts (including patient copayments) rather than charges, because paid amounts are closer approximations of actual transaction cost. If unit costs are used as proxy for paid amounts, disclosure of unit cost values and sources is necessary (eg, institution-specific payments received or costs from a standard source, such as the Medicare Physician Fee Schedule) and must be in line with the stated analytic perspective. The presentation of cost estimates should include a table of the individual unit costs. Measurement of intervention-related resources. In some asthma interventions, measuring intervention-related resources (labor costs, home modifications, etc) not typically captured in administrative data is an important part of establishing the cost and cost-effectiveness of the intervention. For example, in measuring personnel time, the measurement approach should be justified and the limitations acknowledged. Whenever possible, the impact of the chosen method on the cost and cost-effectiveness estimates should be evaluated. How to handle research costs. Research costs (design, implementation, evaluation) should not be included in estimating the cost of the intervention. Reporting recommendations. Transparency and clarity of presentation are critical when reporting cost-effectiveness analysis. Detailed tables and figures describing the inputs, unit cost of input, outcomes, and cost consequences of the intervention(s) should be provided.
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