In the current age of limited health care resources, cost-effectiveness analyses are important since they provide information that can be used by decisionmakers for prioritizing and setting health care policies.
Objective:
This article gives a conceptual overview of cost-effectiveness analyses (CEAs) by discussing their strengths and limitations, introducing the calculations and variables involved, and outlining the issues in interpreting CEAs using dermatological examples.
Conclusion:
Cost-effectiveness analyses are important tools that dermatologists can use to compare medical interventions using costs, effectiveness, and health outcomes.
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References
1.
WeinbergDEngasserP. Dermatologists in Kaiser Permanente-Northern California. Arch Dermatol1996; 132:1057–1063.
2.
SamsWJr. Continuous quality improvement and outcome research: Data for dermatologists to live by. Dermatol World1996; 3–4.
3.
WilsonR. We must have a “cost-effective” change of attitude. J Am Acad Dermatol1987; 17:324–327.
4.
FriedenJ. Dermatologists must prove their cost-effectiveness. Skin Allergy News1996; 30.
5.
WearyP. Public education versus cost-effectiveness study. J Am Acad Dermatol1982; 7:808–810.
6.
ChenSBayoumiAMGoldsteinMK. Cost-comparison analysis versus cost-effectiveness analysis: An important difference. J Am Acad Dermatol1999; 41:1050.
7.
RussellLGoldMSiegelJ. The role of cost-effectiveness analysis in health and medicine. JAMA1996; 276:1172–1177.
8.
WeinsteinMSiegelJGoldM. Recommendations of the Panel on Cost-Effectiveness in Health and Medicine. JAMA1996; 276:1253–1258.
9.
SiegelJWeinsteinMRussellL. Recommendations for reporting cost-effectiveness analyses. JAMA1996; 276:1339–1341.
10.
GoldMSiegelJRussellL. Cost-Effectiveness in Health and Medicine. New York: Oxford University Press, 1996.
11.
O'BrienBHeylandDRichardsonW. Users' guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice. B. What are the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group. JAMA1997; 277:1802–1806.
12.
DrummondMRichardsonWO'BrienB. Users' guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA1997; 277:1552–1557.
13.
HarrisJ. Life: Quality, value and justice. Health Policy1988; 10:259–266.
14.
DrummondMO'BrienBStoddartG. Methods for the Economic Evaluation of Health Care Programmes, 2nd ed.Toronto: Oxford Medical Publishers, 1998.
15.
OwensD. Interpretation of cost-effectiveness analyses. J Gen Intern Med1998; 13:716–717.
16.
GarberAPhelpsC. Economic foundations of cost-effectiveness analysis. J Health Econ1997; 16:1–31.
17.
HlatkyMOwensD. Cost-effectiveness of tests to assess the risk of sudden death after acute myocardial infarction. J Am Coll Cardiol1998; 31:1490–1492.
18.
GoldmanLGarberAGroverS. Cost-effectiveness of assessment and management of risk factors. J Am Coll Cardiol1996; 27:1020–1030.
19.
Carr-HillRA. Allocating resources to health care: Is the QALY (Quality Adjusted Life Year) a technical solution to a political problem?Int J Health Serv1991; 21:351–363.
20.
SmithA. Qualms about QALYs. Lancet1987; 1:1134–1136.
21.
MehrezAGafniA. Healthy-years equivalents versus quality-adjusted life years: In pursuit of progress. Med Decis Making1993; 13:287–292.
22.
MehrezAGafniA. Quality-adjusted life years, utility theory, and healthy-years equivalents. Med Decis Making1989; 9:142–149.
23.
GafniABirchS. Preferences for outcomes in economic evaluation: An economic approach to addressing economic problems. Soc Sci Med1995; 40:767–776.
24.
NordE. An alternative to QALYs: The saved young life equivalent (SAVE). BMJ1992; 305:875–877.
25.
ArnesenTNordE. The value of DALY life: Problems with ethics and validity of disability adjusted life years. BMJ1999; 319:1423–1425.
26.
FrybackDGLawrenceWFJr. Dollars may not buy as many QALYs as we think: A problem with defining quality-of-life adjustments. Med Decis Making1997; 17:276–284.
27.
ReadJLQuinnRJBerwickDM. Preferences for health outcomes. Comparison of assessment methods. Med Decis Making1984;4:315–329.
28.
PliskinJSheppardDWeinsteinM. Utility functions for life years and health states. Oper Res1980; 28:206–224.
29.
KaplanRBushJ. Health-related quality of life measurement for evaluation research and policy analysis. Health Psychol1982; 1:61–80.
30.
BadiaXHerdmanMKindP. The influence of ill-health experience on the valuation of health. Pharmacoeconomics1998; 13:687–696.
31.
SaigalSStoskopfBLFeenyD. Differences in preferences for neonatal outcomes among health care professionals, parents, and adolescents [see comments]. JAMA1999; 281:1991–1997.
32.
BoydNSutherlandHHeasmanK. Whose utilities for decision analysis?Med Decis Making1990; 10:58–67.
