The Use of Cost of Illness (COI) and a Dynamic Analysis of Improvements

Analyzing cost of illness presents useful opportunities for communicating with the public and policymakers on the relative importance of specific diseases and injuries. However, COI studies approaches used in some articles have methodological limitations. The most important one is related to the absence of any measure of utility. The limited use of costs alone, doesn’t permit any acceptable conclusions about the allocation of resources and is not in itself a good tool for decision making. On possible alternative is to include the estimation of life years and quality-adjusted life years (QALYs) lost and the economic burden. This improved COI analysis turns to be an analysis of burden and cost of disease.

This paper includes two parts. First we present the results of an improved COI analysis of stroke in South-west part of Sweden based on the incidence method. This means that we followed the cases that occurred for the first time ever during 2008 and made a projection for the rest of live of the affected patients. We used observation at the individual level during two years and estimated the rest of life comparing our observations with estimations made in other studies before. In the second part, we present a simple dynamic model to trace the time path of costs and health comparing status quo with possible improvements in prevention and treatment. This makes possible a comparison between expected cost variation and QALY variation (quality adjusted life years). This model is intended to be used by decision makers about the expected value for money in alternative improvements that are part of a vision in University Hospital in Gothenburg, Sweden.