This timely volume provides a state-of-the-art review of all research to date on evaluating the cost-effectiveness of HIV prevention programs. Chapters feature comprehensive discussions on both scientific and practical uses - and limitations - of current studies. Addressing key questions about allocating scarce resources to HIV prevention, the Handbook is essential for those who require the most up-to-date research on the methods, findings, and practical uses of economic evaluations. A special feature is the inclusion of helpful tables summarizing the relevant literature.

By almost any criterion of success—be it cost-effectiveness, risk-reward ratio, multiplier
effects, or sheer longevity, the Japan America Security Alliance (JASA) stands out as one of
the most successful alliances in twentieth century history. For the United States, chief
architect of a global network of military relationships, JASA is arguably the most important
of its many bilateral alliances. In terms of historic impact, JASA is comparable to the North
Atlantic Treaty Organization (NATO), a multilateral alliance that restructured the European
security landscape in 1949. For nearly a half-century, JASA and NATO have functioned
as the bedrock on which the Cold War security systems of Asia and Europe have been
constructed.

Published as part of the "America's Alliances with Japan and Korea in a Changing Northeast Asia" Research Project.

Implantable cardioverter defibrillators (ICDs) are remarkably effective in terminating ventricular arrhythmias, but they are expensive and the extent to which they extend life is unknown. The marginal cost-effectiveness of ICDs relative to amiodarone has not been clearly established.

Objective: To compare the cost-effectiveness of a third-generation implantable ICD with that of empirical amiodarone treatment for preventing sudden cardiac death in patients at high or intermediate risk.

Results: For the base-case analysis, it was assumed that treatment with an ICD would reduce the total mortality rate by 20% to 40% at 1 year compared with amiodarone and that the ICD generator would be replaced every 4 years. In high-risk patients, if an ICD reduces total mortality by 20%, patients who receive an ICD live for 4.18 quality-adjusted life-years and have a lifetime expenditure of $88 400. Patients receiving amiodarone live for 3.68 quality-adjusted life-years and have a lifetime expenditure of $51 000. Marginal cost-effectiveness of an ICD relative to amiodarone is $74 400 per quality-adjusted life-year saved. If an ICD reduces mortality by 40%, the cost-effectiveness of ICD use is $37 300 per quality-adjusted life-year saved. Both choice of therapy (an ICD or amiodarone) and the cost-effectiveness ratio are sensitive to assumptions about quality of life.

Conclusions: Use of an ICD will cost more than $50,000 per quality-adjusted life-year gained unless it reduces all-cause mortality by 30% or more relative to amiodarone. Current evidence does not definitively support or exclude a benefit of this magnitude, but ongoing randomized trials have sufficient statistical power to do so.

Pulmonary rehabilitation programmes improve the health of patients disabled by lung disease but their cost eVectiveness is unproved. This cost/utility analysis was undertaken in conjunction with a randomised controlled clinical trial of pulmonary rehabilitation versus standard care.