QALY league table of Iran: a practical method for better resource allocation

Area of Science:

• Health Economics
• Public Health Policy
• Intervention Analysis

Background:

• Limited healthcare resources necessitate careful selection of interventions.
• Decision-makers require evidence to prioritize feasible health programs.
• This study addresses the need for a comprehensive overview of cost-utility analyses in Iran.

Purpose of the Study:

• To systematically review and summarize all cost-utility analysis (CUA) studies conducted in Iran.
• To develop a Quality Adjusted Life Year (QALY) league table for health interventions.
• To inform resource allocation and policy decisions in the Iranian healthcare system.

Main Methods:

• A systematic mapping review was performed, searching multiple databases (PubMed, Embase, Cochrane, Web of Science, Iranian databases) up to January 2020.
• Data extracted included Cost per QALY and Incremental Cost Utility Ratio (ICUR).
• The Joanna Briggs checklist was used for quality appraisal of the included studies.

Main Results:

• 51 CUAs were analyzed, with a focus on cancer (14 studies) and coronary heart diseases (6 studies).
• Markov models were prevalent (45% of studies), with discount rates varying from 0% to 7.2%.
• Cost per QALY varied widely, from $0.144 to over $4.5 million, indicating significant heterogeneity and precluding direct ranking.

Conclusions:

• Summarizing economic evaluation studies provides valuable insights for efficient resource allocation.
• Preventive programs were generally found to be cost-effective across various perspectives in Iran.
• The findings support evidence-based decision-making for optimizing healthcare interventions.