Cost-utility analysis of multiple sclerosis rehabilitation in Iran.

BACKGROUND: Rehabilitation of Multiple Sclerosis (MS) is associated with various clinical, social and economic outcomes. We aimed to evaluate the cost-utility of MS multidisciplinary rehabilitation in Iran. RESEARCH DESIGN AND METHODS: An economic evaluation was conducted using a Markov model designed to reflect the natural course of the disease and interventions. Parameters and variables were extracted from available evidence, and costs and outcomes were calculated from the social perspective. The base-case analysis considered a 5-year time horizon. Costs were estimated based on approved national standards for MS rehabilitation. Sensitivity analyses were also performed. RESULTS: The average cost of the rehabilitation strategy was higher compared to the non-rehabilitation strategy, but it resulted in higher quality-adjusted life years (QALYs) values. The incremental cost-effectiveness ratio (ICER) was found to be $2,845.8 per QALY, indicating that the rehabilitation strategy is cost-effective. In the deterministic sensitivity analysis, extending the time horizon to 10 years made the rehabilitation strategy a dominant choice. Probabilistic sensitivity analysis results were consistent with the base-case findings. CONCLUSIONS: The MS multidisciplinary rehabilitation proved to be a cost-effective strategy; however, the results were sensitive to the input values of the model. Increasing the time horizon increased the probability of rehabilitation being cost-effective.

Cost-benefit analysis of stroke rehabilitation in Iran.

BACKGROUND: The economic evaluation of medication interventions for stroke has been the subject of much economic research. This study aimed to examine the cost-benefit of multidisciplinary rehabilitation services for stroke survivors in Iran. METHODS: This economic evaluation was conducted from the payer's perspective with a lifetime horizon in Iran. A Markov model was designed and Quality-adjusted life years (QALYs) were the final outcomes. First, to evaluate the cost-effectiveness, the incremental cost-effectiveness ratio (ICER) was calculated. Then, using the average net monetary benefit (NMB) of rehabilitation, the average Incremental Net Monetary Benefit (INMB) per patient was calculated. The analyses were carried out separately for public and private sector tariffs. RESULTS: While considering public tariffs, the rehabilitation strategy had lower costs (US$5320 vs. US$ 6047) and higher QALYs (2.78 vs. 2.61) compared to non-rehabilitation. Regarding the private tariffs, the rehabilitation strategy had slightly higher costs (US$6,698 vs. US$6,182) but higher QALYs (2.78 vs. 2.61) compared to no rehabilitation. The average INMB of rehabilitation vs non-rehabilitation for each patient was estimated at US$1518 and US$275 based on Public and private tariffs, respectively. CONCLUSION: Providing multidisciplinary rehabilitation services to stroke patients was cost-effective and has positive INMBs in public and private tariffs.