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COST EFFECTIVENESS - CALCULATOR AND GRAPHER
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Copyright (c) Health Decision Strategies, LLC
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*** Data Entry Form ***
(Modify values in yellow boxes and hit "calculate" button)
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I. TITLE OF ANALYSIS:
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II.
STUDY OBJECTIVES:
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III.
STUDY PERSPECTIVE:
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Society
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Patient
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Payer
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Provider
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Miscellaneous
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IV.
TYPE OF ANALYSIS:
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COI
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CMA
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CBA
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CEA
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CUA
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V.
TREATMENT OPTIONS:
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Names of Treatment:
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Disease/Symptom:
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Major Outcome Measure:
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VI.
COST FACTORS
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A.
DIRECT COSTS:
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( HEALTH CARE RESOURCES)
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B.
DIRECT COSTS:
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(NON-HEALTH CARE RESOURCES)
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TOTAL
DIRECT COSTS
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C. INDIRECT COSTS
(BENEFITS)
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Morbidity
& Mortality (time gained for work yrs)
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Salary per year
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Morbidity
& Mortality (benefit gained $)
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D. QUALITY OF LIFE
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Quality of Life --
Adjustment Factor
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Quality Adjusted Life
Years
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VII.
ANALYSIS OPTIONS
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Outcomes
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Outcomes
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For
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COI
(direct and indirect costs of illness)
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DOLLARS
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DOLLARS
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For
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CMA
( outcomes are assumed equal)
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EQUAL
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EQUAL
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For
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CEA ( outcomes in natural
units.)
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Yrs,mmHg,etc.
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Yrs,mmHg,etc.
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For
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CBA
[NPV] ( outcomes all in dollars)
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DOLLARS
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DOLLARS
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For
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CUA ( outcomes in
utiles,QALYs)
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QALYs, DALYs, etc
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QALYs,DALYs, etc
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VIII. CALCULATED RESULTS:
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(Ratios are Input Costs divided by Outcomes.)
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COI
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(direct and indirect
costs of illness)
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COI
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CMA
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( input costs only,
outcomes equal)
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CMA
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CEA
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(cost over effect ratio)
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CEA
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CBA
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[NPV] (benefit
minus input cost)
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CBA
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CUA
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(cost over utility adjusted effect)
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CUA
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Copyright
(c) Health Decision Strategies, LLC -- www.HealthStrategy.com
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