IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v35y2015i7p818-846.html
   My bibliography  Save this article

Evaluating Cost-effectiveness of Interventions That Affect Fertility and Childbearing

Author

Listed:
  • Jeremy D. Goldhaber-Fiebert
  • Margaret L. Brandeau

Abstract

Background. Current guidelines for economic evaluations of health interventions define relevant outcomes as those accruing to individuals receiving interventions. Little consensus exists on counting health impacts on current and future fertility and childbearing. Our objective was to characterize current practices for counting such health outcomes. Methods. We developed a framework characterizing health interventions with direct and/or indirect effects on fertility and childbearing and how such outcomes are reported. We identified interventions spanning the framework and performed a targeted literature review for economic evaluations of these interventions. For each article, we characterized how the potential health outcomes from each intervention were considered, focusing on quality-adjusted life-years (QALYs) associated with fertility and childbearing. Results. We reviewed 108 studies, identifying 7 themes: 1) Studies were heterogeneous in reporting outcomes. 2) Studies often selected outcomes for inclusion that tend to bias toward finding the intervention to be cost-effective. 3) Studies often avoided the challenges of assigning QALYs for pregnancy and fertility by instead considering cost per intermediate outcome. 4) Even for the same intervention, studies took heterogeneous approaches to outcome evaluation. 5) Studies used multiple, competing rationales for whether and how to include fertility-related QALYs and whose QALYs to include. 6) Studies examining interventions with indirect effects on fertility typically ignored such QALYs. 7) Even recent studies had these shortcomings. Limitations include that the review was targeted rather than systematic. Conclusions. Economic evaluations inconsistently consider QALYs from current and future fertility and childbearing in ways that frequently appear biased toward the interventions considered. As the Panel on Cost-Effectiveness in Health and Medicine updates its guidelines, making the practice of cost-effectiveness analysis more consistent is a priority. Our study contributes to harmonizing methods in this respect.

Suggested Citation

  • Jeremy D. Goldhaber-Fiebert & Margaret L. Brandeau, 2015. "Evaluating Cost-effectiveness of Interventions That Affect Fertility and Childbearing," Medical Decision Making, , vol. 35(7), pages 818-846, October.
  • Handle: RePEc:sae:medema:v:35:y:2015:i:7:p:818-846
    DOI: 10.1177/0272989X15583845
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X15583845
    Download Restriction: no

    File URL: https://libkey.io/10.1177/0272989X15583845?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Joseph S. Pliskin & Donald S. Shepard & Milton C. Weinstein, 1980. "Utility Functions for Life Years and Health Status," Operations Research, INFORMS, vol. 28(1), pages 206-224, February.
    2. Garber, Alan M. & Phelps, Charles E., 2008. "Future costs and the future of cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 27(4), pages 819-821, July.
    3. Gary Ginsberg & Hannah Blau & Eitan Kerem & Chaim Springer & Bat‐Sheba Kerem & Edna Akstein & Alan Greenberg & Ami Kolumbos & Devorah Abeliovich & Eli Gazit & Jacob Yahav, 1994. "Cost‐benefit analysis of a national screening programme for cystic fibrosis in an israeli population," Health Economics, John Wiley & Sons, Ltd., vol. 3(1), pages 5-23, January.
    4. Judit Simon & Stavros Petrou & Alastair Gray, 2009. "The valuation of prenatal life in economic evaluations of perinatal interventions," Health Economics, John Wiley & Sons, Ltd., vol. 18(4), pages 487-494, April.
    5. Llanos, Adolfo & Hertrampf, Eva & Cortes, Fanny & Pardo, Andrea & Grosse, Scott D. & Uauy, Ricardo, 2007. "Cost-effectiveness of a folic acid fortification program in Chile," Health Policy, Elsevier, vol. 83(2-3), pages 295-303, October.
    6. Randi Nielsen & Dorte Gyrd‐Hansen, 2002. "Prenatal screening for cystic fibrosis: an economic analysis," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 285-299, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jeroen Luyten & Evelyn Verbeke & Erik Schokkaert, 2022. "To be or not to be: Future lives in economic evaluation," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 258-265, January.
    2. Kibel, Mia & Vanstone, Meredith, 2017. "Reconciling ethical and economic conceptions of value in health policy using the capabilities approach: A qualitative investigation of Non-Invasive Prenatal Testing," Social Science & Medicine, Elsevier, vol. 195(C), pages 97-104.
    3. Lisbet S. Lundsberg & Eleanor B. Schwarz & Nicole A. Vilardo & Kimberly A. Yonkers & Aileen M. Gariepy, 2018. "Clinical Validation of PROMIS Global Short Form in Pregnancy," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 13(1), pages 89-103, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bengt Liljas, 2011. "Welfare, QALYs, and costs – a comment," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 68-72, January.
    2. Ryan Edwards, 2013. "The cost of uncertain life span," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(4), pages 1485-1522, October.
    3. Lars Peter Østerdal, 2004. "Exponential Health Utility: A Characterization and Comments on a Paper by Happich and Mühlbacher," Discussion Papers 04-04, University of Copenhagen. Department of Economics.
    4. Gordon Hazen, 2004. "Multiattribute Structure for QALYs," Decision Analysis, INFORMS, vol. 1(4), pages 205-216, December.
    5. Hougaard, Jens Leth & Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2013. "A new axiomatic approach to the evaluation of population health," Journal of Health Economics, Elsevier, vol. 32(3), pages 515-523.
    6. SeungJin Bae & SooOk Lee & Eun Bae & Sunmee Jang, 2013. "Korean Guidelines for Pharmacoeconomic Evaluation (Second and Updated Version)," PharmacoEconomics, Springer, vol. 31(4), pages 257-267, April.
    7. Attema, Arthur E. & Brouwer, Werner B.F., 2012. "A test of independence of discounting from quality of life," Journal of Health Economics, Elsevier, vol. 31(1), pages 22-34.
    8. Anna Scherbina, 2021. "Assessing the Optimality of a COVID Lockdown in the United States," Economics of Disasters and Climate Change, Springer, vol. 5(2), pages 177-201, July.
    9. Attema, Arthur E. & l’Haridon, Olivier & van de Kuilen, Gijs, 2019. "Measuring multivariate risk preferences in the health domain," Journal of Health Economics, Elsevier, vol. 64(C), pages 15-24.
    10. Johannesson, Magnus, 1995. "Qalys: A comment," Journal of Public Economics, Elsevier, vol. 56(2), pages 327-328, February.
    11. Kvamme, Maria Knoph & Gyrd-Hansen, Dorte & Olsen, Jan Abel & Kristiansen, Ivar Sønbø, 2010. "Increasing marginal utility of small increases in life-expectancy?: Results from a population survey," Journal of Health Economics, Elsevier, vol. 29(4), pages 541-548, July.
    12. McNamara, Simon & Tsuchiya, Aki & Holmes, John, 2021. "Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment," Social Science & Medicine, Elsevier, vol. 269(C).
    13. John M. Miyamoto & Peter P. Wakker & Han Bleichrodt & Hans J. M. Peters, 1998. "The Zero-Condition: A Simplifying Assumption in QALY Measurement and Multiattribute Utility," Management Science, INFORMS, vol. 44(6), pages 839-849, June.
    14. Heather J. Sutherland & Hilary Llewellyn-Thomas & Norman F. Boyd & James E. Till, 1982. "Attitudes Toward Quality of Survival," Medical Decision Making, , vol. 2(3), pages 299-309, August.
    15. John M. Miyamoto & Stephen A. Eraker, 1985. "Parameter Estimates for a QALY Utility Model," Medical Decision Making, , vol. 5(2), pages 191-213, June.
    16. Stephen G. Pauker, 2014. "Moments When Utilities Are Functional," Medical Decision Making, , vol. 34(1), pages 4-7, January.
    17. Ryen, Linda & Svensson, Mikael, 2014. "The Willingness to Pay for a QALY: a Review of the Empirical Literature," Karlstad University Working Papers in Economics 12, Karlstad University, Department of Economics.
    18. Stefan A. Lipman & Liying Zhang & Koonal K. Shah & Arthur E. Attema, 2023. "Time and lexicographic preferences in the valuation of EQ-5D-Y with time trade-off methodology," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(2), pages 293-305, March.
    19. Milton C. Weinstein, 1981. "Economic Assessments of Medical Practices and Technologies," Medical Decision Making, , vol. 1(4), pages 309-330, December.
    20. Han Bleichrodt & Jose Maria Abellan-Perpiñan & Jose Luis Pinto-Prades & Ildefonso Mendez-Martinez, 2007. "Resolving Inconsistencies in Utility Measurement Under Risk: Tests of Generalizations of Expected Utility," Management Science, INFORMS, vol. 53(3), pages 469-482, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:35:y:2015:i:7:p:818-846. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.