For Case Study 4, you will read the case that begins on page 609 "Capstone Case H: Cost-Effectiveness Analyses of Type II Diabetes."

You are to answer the following questions only from the case study:

• Question 1

What is the difference between cost-benefit, cost-effectiveness, and cost-utility analysis?

Question 2

What is the relationship between cost and effectiveness? Does more effectiveness always cost more money?

Question 3

When doing CEA it is important to identify the perspective from which the analysis is conducted. In other words, from whose perspective are the costs and benefits recognized? What are the different perspectives? With diabetes CEA, a single-pay perspective is assumed. What does this mean, and what kinds of costs are ignored?

Question 8

The authors (CDC diabetes Cost-Effectiveness Group 1998) evaluated screening within different age intervals and reported screening costs and treatment costs for those screened at ages 25-34 ($5,933 and $96,085, respectively), ages 35-44 ($2,629 and $77456, respectively), ages 45-54 ($1,006 and $59,448, respectively), ages 55-64 ($715 and $44,334 respectively), and 65 and older ($524 and $32,490, respectively). Treatment costs for the unscreened in each of the five groups were $97,360, $76,098, $56,167, $40,254, and $27,903, respectively. Calculate the incremental treatment costs associated with screening in each of the age groups.

As expected, the complication of end-stage renal disease (ESRD) would occur less frequently among those screened and for whom diabetes treatment could be sought. The model predicts cumulative incidence rates for ESRD for the unscreened and screened age 25-34 (19.2 percent and 15.9 percent, respectively), age 35-44 (10.3 percent and 8.0 percent, respectively), age 45-54 (4.2 percent and 3.0 percent, respectively), 55-64 (1.4 percent and 0.9 percent, respectively) and 65 older (0.3 percent and 0.2 percent, respectively),. The model assumes that ESRD is associated with costs of $68m131 per person per year.,

Question 9

Assume that 1,000 subjects in each age cohort have been followed until age 65, have survived, but have developed ESRD at the rates listed Above. Calculate the risk difference (i.e., difference in rates) the cumulative incidence in each age group, the total costs of this complication, and the savings that can be attributable to screening..