Cost-Value Analysis and the SAVE: A Work in Progress, But an Option for Localised Decision Making?

Area of Science:

• Health Economics
• Decision Science
• Public Health Policy

Background:

• Cost-value analysis seeks to integrate fairness into healthcare resource allocation, addressing limitations of the quality-adjusted life-year (QALY).
• Current value measurement often uses equity weights for QALY gains.
• An alternative approach involves non-QALY measures, such as the Saving a Young Person’s Life (SAVE).

Purpose of the Study:

• To assess the feasibility and validity of using SAVE as a value measure in healthcare economic evaluations.
• To determine the potential of SAVE as an alternative to QALYs for specific decision-making contexts.

Main Methods:

• A web-based person trade-off (PTO) survey was developed to estimate equivalent SAVEs for breast cancer outcomes.
• The estimated SAVEs were applied to an existing decision analytic model for early breast cancer.

Main Results:

• 1094 respondents completed the web-based PTO survey.
• Validation showed varying degrees of response consistency and transitivity.
• The mean incremental cost per SAVE gained was estimated at £3.72 million using consistent responses.

Conclusions:

• Further research is needed to enhance SAVE's validity, potentially through simplified survey formats.
• SAVE is unlikely to supplant QALYs globally but may serve as a valuable tool for localized, budget-constrained decision-making, such as in programme budgeting and marginal analysis.