Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-25T19:04:04.886Z Has data issue: false hasContentIssue false

Cost-effectiveness analysis for priority setting in health: Penny-wise but pound-foolish

Published online by Cambridge University Press:  25 October 2005

Rob Baltussen
Affiliation:
Erasmus Medical Centre Rotterdam
Werner Brouwer
Affiliation:
Erasmus Medical Centre Rotterdam
Louis Niessen
Affiliation:
Erasmus Medical Centre Rotterdam

Abstract

Cost-effectiveness analysis has much conceptual attractiveness in priority setting but is not used to its full potential to assist policy-makers on making choices in health in developed or in developing countries. We call for a shift away from present economic evaluation activities—that tend to produce ad hoc and incomparable economic evaluation studies and, therefore, add little to the compendium of knowledge of cost-effectiveness of health interventions in general—toward a more systematic approach. Research efforts in economic evaluation should build on the foundations of cost-effectiveness research of the past decades to arrive at an informative methodology useful for national policy-makers. This strategy means that governments should steer sectoral cost-effectiveness analysis to obtain systematic and comprehensive information on the economic attractiveness of a set of new and current interventions, using a standardized methodology and capturing interactions between interventions. Without redirecting the focus of economic evaluation research, choosing in health care bears the risk to remain penny-wise but pound-foolish.

Type
RESEARCH REPORTS
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bobadilla JL, Cowley P, Musgrove P, Saxenian H. 1994 Design, content and financing of an essential national package of health services. Bull World Health Organ. 72: 653662.Google Scholar
Bryant J, Cave C, Mihaylova B, et al. 2002 Clinical effectiveness and cost-effectiveness of growth hormone in children: A systematic review and economic evaluation. Health Technol Assess. 6: 1168.Google Scholar
Churchill RHV, Corney R, Knapp M, et al. 2001 A systematic review of controlled trials of the effectiveness and cost-effectiveness of brief psychological treatments for depression. Health Technol Assess. 5: 1173.Google Scholar
Eichler HG, Kong SX, Gerth WC, Mavros P, Jonsson B. 2004 Use of cost-effectiveness analysis in health-care resource allocation decision-making: How are cost-effectiveness thresholds expected to emerge? Value Health. 7: 518528.Google Scholar
EuroScan. 2005. The European Information Network on New and Changing Health Technologies. Available at: http://www. publichealth.bham.ac.uk/euroscan/members/current.htm. Accessed May 15
Gafni A, Birch S. 2003 NICE methodological guidelines and decision making in the National Health Service in England and Wales. Pharmacoeconomics. 21: 149157.Google Scholar
Holloway RG, Benesch CG, Rahilly CR, Courtright CE. 1999 A systematic review of cost-effectiveness research of stroke evaluation and treatment. Stroke. 30: 13401349.Google Scholar
Jamison DT, Mosley WH, Measham AR, Bobadilla JL. 1993. Disease control priorities in developing countries. New York: Oxford University Press;
Klonoff DC, Schwartz DM. 2000 An economic analysis of interventions for diabetes. Diabetes Care 23: 390404.Google Scholar
Murray CJ, Evans DB, Acharya A, Baltussen RM. 2000 Development of WHO guidelines on generalized cost-effectiveness analysis. Health Econ. 9: 235251.Google Scholar
Norderhaug I, Dahl O, Hoisaeter PA, et al. 2003 Brachytherapy for prostate cancer: A systematic review of clinical and cost effectiveness. Eur Urol. 44: 4046.Google Scholar
Oregon HSC. 1991 Oregon Medicaid priority setting project. Eugene: Oregon State Government;
Pignone M, Saha S, Hoerger T, Mandelblatt J. 2002 Cost-effectiv- eness analyses of colorectal cancer screening: A systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 137: 96104.Google Scholar
Robinson R. 1999 Limits to rationality: Economics, economists and priority setting. Health Policy. 49: 1326.Google Scholar
Rutten FF, Brouwer WB. 2002 Meer zorg bij beperkt budget; een pleidooi voor een betere inzet van het doelmatigheidscriterium (in Dutch). Ned Tijdsch v Geneesk. 146: 22542258.Google Scholar
Stinnett AA, Paltiel AD. 1996 Mathematical programming for the efficient allocation of health care resources. J Health Econ. 15: 641653.Google Scholar
Tan Torres T, Baltussen R, Adam T. et al. 2003. WHO guide to cost-effectiveness analysis. Geneva: World Health Organization;
Tella MN, Feinglass J, Chang RW. 2003 Cost-effectiveness, cost-utility, and cost-benefit studies in rheumatology: A review of the literature, 2001-2002. Curr Opin Rheumatol. 15: 127131.Google Scholar
Tenbesnel T. 2002 Interpreting public input into priority-setting: The role of mediating institutions. Health Policy. 62: 173194.Google Scholar
Tengs TO, Adams ME, Pliskin JS, et al. 1995 Five-hundred life-saving interventions and their cost-effectiveness. Risk Anal. 15: 369390.Google Scholar
Weinstein MC, Stason WB. 1977 Foundations of cost-effectiveness analysis for health and medical practices. N Engl J Med. 296: 716721.Google Scholar