Limits on health-care resources mandate that resource-allocation decisions be guided by considerations of cost in relation to expected benefits. In cost-effectiveness analysis, the ratio of net health-care costs to net health benefits provides an index by which priorities may be set. Quality-of-life concerns, including both adverse and beneficial effects of therapy, may be incorporated in the calculation of health benefits as adjustments to life expectancy. The timing of future benefits and costs may be accounted for by the appropriate use of discounting. Current decisions must inevitably be based on imperfect information, but sensitivity analysis can increase the level of confidence in some decisions while suggesting areas where further research may be valuable in guiding others. Analyses should be adaptable to the needs of various health-care decision makers, including planners, administrators and providers.
This article has been cited by other articles:
Chisin, R.
(2009). Cost-Effectiveness Analysis. JNM
50: 338-339
[Full Text]
Cohen, D. J., Reynolds, M. R.
(2008). Interpreting the results of cost-effectiveness studies.. J Am Coll Cardiol
52: 2119-2126
[Abstract][Full Text]
Firth, B. G., Cooper, L. M., Fearn, S.
(2008). The Appropriate Role Of Cost-Effectiveness In Determining Device Coverage: A Case Study Of Drug-Eluting Stents. Health Aff (Millwood)
27: 1577-1586
[Abstract][Full Text]
Arnold, S. V., Morrow, D. A., Wang, K., Lei, Y., Mahoney, E. M., Scirica, B. M., Braunwald, E., Cohen, D. J., on behalf of the MERLIN-TIMI 36 Investigators,
(2008). Effects of Ranolazine on Disease-Specific Health Status and Quality of Life Among Patients With Acute Coronary Syndromes: Results from the MERLIN-TIMI 36 Randomized Trial. Circ Cardiovasc Qual Outcomes
1: 107-115
[Abstract][Full Text]
Poon, C. S.
(2008). A Brief Commentary on Cost-Effectiveness Analysis in Radiologic Research. Am. J. Roentgenol.
191: 1320-1322
[Abstract][Full Text]
Soares, M., Dumville, J. C
(2008). Critical appraisal of cost-effectiveness and cost-utility studies in health care. Evid. Based Nurs.
11: 99-102
[Full Text]
Alehagen, U., Rahmqvist, M., Paulsson, T., Levin, L.-A.
(2008). Quality-adjusted life year weights among elderly patients with heart failure. Eur J Heart Fail
10: 1033-1039
[Abstract][Full Text]
VanBeek, M. J.
(2008). Integrating Patient Preferences With Health Utilities: A Variation on Health-Related Quality of Life. Arch Dermatol
144: 1037-1041
[Full Text]
Sharifi, E., Sharifi, H., Morshed, S., Bozic, K., Diab, M.
(2008). Cost-Effectiveness Analysis of Periacetabular Osteotomy. JBJS
90: 1447-1456
[Abstract][Full Text]
Schlander, M
(2008). The use of cost-effectiveness by the National Institute for Health and Clinical Excellence (NICE): no(t yet an) exemplar of a deliberative process. J. Med. Ethics
34: 534-539
[Abstract][Full Text]
Bravo Vergel, Y., Sculpher, M.
(2008). Quality-adjusted life years. PN
8: 175-182
[Abstract][Full Text]
Shermock, K. M., Horn, E., Rice, T. L.
(2008). Erythropoietic agents for anemia of critical illness. Am J Health Syst Pharm
65: 540-546
[Abstract][Full Text]
Shechter, S. M., Bailey, M. D., Schaefer, A. J., Roberts, M. S.
(2008). The Optimal Time to Initiate HIV Therapy Under Ordered Health States. Operations Research
56: 20-33
[Abstract]
Krabbe, P. F. M., Salomon, J. A., Murray, C. J. L.
(2007). Quantification of Health States with Rank-Based Nonmetric Multidimensional Scaling. Med Decis Making
27: 395-405
[Abstract]
Myers, J., McCabe, S., Gohmann, S.
(2007). Quality-of-Life Assessment When There Is a Loss of Income. Med Decis Making
27: 27-33
[Abstract]
Hilty, D. M., Benjamin, S., Briscoe, G., Hales, D. J., Boland, R. J., Luo, J. S., Chan, C. H., Kennedy, R. S., Karlinsky, H., Gordon, D. B., Yellowlees, P. M., Yager, J.
(2006). APA Summit on Medical Student Education Task Force on Informatics and Technology: Steps to Enhance the Use of Technology in Education Through Faculty Development, Funding and Change Management. Acad. Psychiatry
30: 444-450
[Abstract][Full Text]
Gray, A. M
(2006). Cost-effectiveness analyses alongside randomised clinical trials. Clin Trials
3: 538-542
[Abstract]
Ryan, J., Cohen, D. J.
(2006). Are Drug-Eluting Stents Cost-Effective?: It Depends on Whom You Ask. Circulation
114: 1736-1744
[Full Text]
Soohoo, N. F., Sharifi, H., Kominski, G., Lieberman, J. R.
(2006). Cost-Effectiveness Analysis of Unicompartmental Knee Arthroplasty as an Alternative to Total Knee Arthroplasty for Unicompartmental Osteoarthritis. JBJS
88: 1975-1982
[Abstract][Full Text]
Hoel, M.
(2006). Cost-Effectiveness Analysis in the Health Sector when There is a Private Alternative to Public Treatment. CESifo Economic Studies
52: 500-512
[Abstract][Full Text]
Vergnenegre, A., Combescure, C., Fournel, P., Bayle, S., Gimenez, C., Souquet, P. J., Lena, H., Perol, M., Delhoume, J. Y., GFPC (Groupe Francais de Pneumo-Cancerologie),
(2006). Cost-minimization analysis of a phase III trial comparing concurrent versus sequential radiochemotherapy for locally advanced non-small-cell lung cancer (GFPC-GLOT 95-01). Ann Oncol
17: 1269-1274
[Abstract][Full Text]
Paskett, E. D., Schrag, D., Kornblith, A., Lamont, E. B., Weeks, J. C., Marshall, J. R., Shapiro, C., Holland, J.
(2006). Cancer and leukemia group B cancer control and health outcomes committee: origins and accomplishments.. Clin. Cancer Res.
12: 3601s-3605s
[Abstract][Full Text]
Reilly, B. M., Evans, A. T.
(2006). Translating Clinical Research into Clinical Practice: Impact of Using Prediction Rules To Make Decisions. ANN INTERN MED
144: 201-209
[Abstract][Full Text]
Firoz, B. F., Lee, S. J., Nghiem, P., Qureshi, A. A.
(2006). Role of Skin Biopsy to Confirm Suspected Acute Graft-vs-Host Disease: Results of Decision Analysis.. Arch Dermatol
142: 175-182
[Abstract][Full Text]
Sejean, K., Calmus, S., Durand-Zaleski, I., Bonnichon, P., Thomopoulos, P., Cormier, C., Legmann, P., Richard, B., Bertagna, X. Y, Vidal-Trecan, G. M
(2005). Surgery versus medical follow-up in patients with asymptomatic primary hyperparathyroidism: a decision analysis. Eur J Endocrinol
153: 915-927
[Abstract][Full Text]
Gupta, V, Srinivasan, G, Mei, S S, Gazzard, G, Sihota, R, Kapoor, K S
(2005). Utility values among glaucoma patients: an impact on the quality of life. Br J Ophthalmol
89: 1241-1244
[Abstract][Full Text]
Brouwer, W. B F, Niessen, L. W, Postma, M. J, Rutten, F. F H
(2005). Need for differential discounting of costs and health effects in cost effectiveness analyses. BMJ
331: 446-448
[Full Text]
Garland, A.
(2005). Improving the ICU: Part 1. Chest
127: 2151-2164
[Abstract][Full Text]
Simunovic, M., Gafni, A., Levine, M.
(2005). In Reply:. JCO
23: 3633-3634
[Full Text]
Gazelle, G. S., McMahon, P. M., Siebert, U., Beinfeld, M. T.
(2005). Cost-effectiveness Analysis in the Assessment of Diagnostic Imaging Technologies. Radiology
235: 361-370
[Abstract][Full Text]
Baxter, Y. C., Dias, M. C. G., Maculevicius, J., Cecconello, I., Cotteleng, B., Waitzberg, D. L.
(2005). Economic Study in Surgical Patients of a New Model of Nutrition Therapy Integrating Hospital and Home vs the Conventional Hospital Model. JPEN J Parenter Enteral Nutr
29: S96-S105
[Abstract][Full Text]
Wakker, P. P., Jansen, S. J. T., Stiggelbout, A. M.
(2004). Anchor Levels as a New Tool for the Theory and Measurement of Multiattribute Utility. Decision Analysis
1: 217-234
[Abstract]
Kocher, M. S., Bishop, J. A., Hresko, M. T., Millis, M. B., Kim, Y.-J., Kasser, J. R.
(2004). Prophylactic Pinning of the Contralateral Hip After Unilateral Slipped Capital Femoral Epiphysis. JBJS
86: 2658-2665
[Abstract][Full Text]
Gray, D. T.
(2004). Neonatal Circumcision: Cost-Effective Preventive Measure or "the Unkindest Cut of All"?. Med Decis Making
24: 688-692
SooHoo, N. F., Kominski, G.
(2004). Cost-Effectiveness Analysis of Total Ankle Arthroplasty. JBJS
86: 2446-2455
[Abstract][Full Text]
Alagoz, O., Maillart, L. M., Schaefer, A. J., Roberts, M. S.
(2004). The Optimal Timing of Living-Donor Liver Transplantation. Management Science
50: 1420-1430
[Abstract]
Salomon, J. A, Weinstein, M. C, Goldie, S. J
(2004). Taking account of future technology in cost effectiveness analysis. BMJ
329: 733-736
[Full Text]
Kocher, M. S., Zurakowski, D.
(2004). Clinical Epidemiology and Biostatistics: A Primer for Orthopaedic Surgeons. JBJS
86: 607-620
[Full Text]
Greenberg, D., Bakhai, A., Cohen, D. J.
(2004). Can we afford to eliminate restenosis?: Can we afford not to?. J Am Coll Cardiol
43: 513-518
[Abstract][Full Text]
Minelli, C., Abrams, K. R, Sutton, A. J, Cooper, N. J
(2004). Benefits and harms associated with hormone replacement therapy: clinical decision analysis. BMJ
328: 371-
[Abstract][Full Text]
Simunovic, M., Gafni, A., Levine, M.
(2004). Economics of Preoperative Radiotherapy With Total Mesorectal Excision: What Can We Learn From the Dutch Experience?. JCO
22: 217-219
[Full Text]
Medina, L. S., Aguirre, E., Bernal, B., Altman, N. R.
(2004). Functional MR Imaging versus Wada Test for Evaluation of Language Lateralization: Cost Analysis. Radiology
230: 49-54
[Abstract][Full Text]
Andreoli, P. B. d. A., Citero, V. d. A., Mari, J. d. J.
(2003). A Systematic Review of Studies of the Cost-Effectiveness of Mental Health Consultation-Liaison Interventions in General Hospitals. Psychosomatics
44: 499-507
[Abstract][Full Text]
Arnesen, T M, Norheim, O F
(2003). Quantifying quality of life for economic analysis: time out for time trade off. Med. Humanities
29: 81-86
[Abstract][Full Text]
Stiell, I., Nichol, G., Wells, G., De Maio, V., Nesbitt, L., Blackburn, J., Spaite, D., for the OPALS Study Group,
(2003). Health-Related Quality of Life Is Better for Cardiac Arrest Survivors Who Received Citizen Cardiopulmonary Resuscitation. Circulation
108: 1939-1944
[Abstract][Full Text]
Sisk, J. E., Whang, W., Butler, J. C., Sneller, V.-P., Whitney, C. G.
(2003). Cost-Effectiveness of Vaccination against Invasive Pneumococcal Disease among People 50 through 64 Years of Age: Role of Comorbid Conditions and Race. ANN INTERN MED
138: 960-968
[Abstract][Full Text]
Gafni, A., Birch, S.
(2003). Inclusion of drugs in provincial drug benefit programs: Should "reasonable decisions" lead to uncontrolled growth in expenditures?. CMAJ
168: 849-851
[Full Text]
Goyen, M., Herborn, C. U., Kroger, K., Lauenstein, T. C., Debatin, J. F., Ruehm, S. G.
(2003). Detection of Atherosclerosis: Systemic Imaging for Systemic Disease with Whole-Body Three-dimensional MR Angiography-- Initial Experience. Radiology
227: 277-282
[Abstract][Full Text]
Gray, D. T., Veenstra, D. L.
(2003). Comparative economic analyses of minimally invasive direct coronary artery bypass surgery. J. Thorac. Cardiovasc. Surg.
125: 618-624
[Abstract][Full Text]
Mokrzycki, M. H., Singhal, A.
(2002). Cost-effectiveness of three strategies of managing tunnelled, cuffed haemodialysis catheters in clinically mild or asymptomatic bacteraemias. Nephrol Dial Transplant
17: 2196-2203
[Abstract][Full Text]
Brown, M. J.
(2002). Costs and Benefits of Enforcing Housing Policies to Prevent Childhood Lead Poisoning. Med Decis Making
22: 482-492
[Abstract]
Chakravorty, I., Cayton, R.M., Szczepura, A.
(2002). Health utilities in evaluating intervention in the sleep apnoea/hypopnoea syndrome. Eur Respir J
20: 1233-1238
[Abstract][Full Text]
Capomolla, S., Febo, O., Ceresa, M., Caporotondi, A., Guazzotti, G., La Rovere, M. T., Ferrari, M., Lenta, F., Baldin, S., Vaccarini, C., Gnemmi, M., Pinna, G., Maestri, R., Abelli, P., Verdirosi, S., Cobelli, F.
(2002). Cost/utility ratio in chronic heart failure: comparison between heart failure management program delivered by day-hospital and usual care. J Am Coll Cardiol
40: 1259-1266
[Abstract][Full Text]
Pepper, P. V., Owens, D. K.
(2002). Cost-Effectiveness of the Pneumococcal Vaccine in Healthy Younger Adults. Med Decis Making
22: S45-S57
[Abstract]
Medina, L. S., Richardson, R. R., Crone, K.
(2002). Children with Suspected Craniosynostosis: A Cost-Effectiveness Analysis of Diagnostic Strategies. Am. J. Roentgenol.
179: 215-221
[Abstract][Full Text]
Watson, R. S., Angus, D. C.
(2002). Assessing Outcomes in Critical Care. J Intensive Care Med
17: 103-111
[Abstract]
Bree, R. L., Carlos, R. C.
(2002). US for Postmenopausal Bleeding: Consensus Development and Patient-centered Outcomes. Radiology
222: 595-598
[Full Text]
Bonneux, L
(2002). How to measure the burden of mortality?. J. Epidemiol. Community Health
56: 128-131
[Abstract][Full Text]
Stein, K, Rosenberg, W, Wong, J
(2002). Cost effectiveness of combination therapy for hepatitis C: a decision analytic model. Gut
50: 253-258
[Abstract][Full Text]
Sonnenberg, A., Delco, F.
(2002). Cost-effectiveness of a Single Colonoscopy in Screening for Colorectal Cancer. Arch Intern Med
162: 163-168
[Abstract][Full Text]
Esnaola, N. F., Lazarides, S. N., Mentzer, S. J., Kuntz, K. M.
(2002). Outcomes and Cost-Effectiveness of Alternative Staging Strategies for Non-Small-Cell Lung Cancer. JCO
20: 263-273
[Abstract][Full Text]
Blackmore, C. C., Zelman, W. N., Glick, N. D.
(2001). Resource Cost Analysis of Cervical Spine Trauma Radiography. Radiology
220: 581-587
[Abstract][Full Text]
Weinstein, M. C
(2001). Should physicians be gatekeepers of medical resources?. J. Med. Ethics
27: 268-274
[Abstract][Full Text]
Medina, L. S., Kuntz, K. M., Pomeroy, S.
(2001). Children With Headache Suspected of Having a Brain Tumor: A Cost-Effectiveness Analysis of Diagnostic Strategies. Pediatrics
108: 255-263
[Abstract][Full Text]
Singer, M. E., Applegate, K. E.
(2001). Cost-Effectiveness Analysis in Radiology. Radiology
219: 611-620
[Abstract][Full Text]
Gaynon, P. S., Bostrom, B. C., Hutchinson, R. J., Lange, B. J., Nachman, J. B., Steinherz, P. G., Sensel, M. G., Lee, M. K., Stram, D. O., Sather, H. N.
(2001). Duration of Hospitalization as a Measure of Cost on Children's Cancer Group Acute Lymphoblastic Leukemia Studies. JCO
19: 1916-1925
[Abstract][Full Text]
Brown, M. M, Brown, G. C, Sharma, S., Kistler, J., Brown, H.
(2001). Utility values associated with blindness in an adult population. Br J Ophthalmol
85: 327-331
[Abstract][Full Text]
Bonneux, L, Birnie, E
(2001). The discount rate in the economic evaluation of prevention: a thought experiment. J. Epidemiol. Community Health
55: 123-125
[Abstract][Full Text]
Phillips, K. A., Shlipak, M. G., Coxson, P., Heidenreich, P. A., Hunink, M. G. M., Goldman, P. A., Williams, L. W., Weinstein, M. C., Goldman, L.
(2000). Health and Economic Benefits of Increased {beta}-Blocker Use Following Myocardial Infarction. JAMA
284: 2748-2754
[Abstract][Full Text]
Lehoux, P., Blume, S.
(2000). Technology Assessment and the Sociopolitics of Health Technologies. Journal of Health Politics, Policy and Law
25: 1083-1120
[Abstract]
Holloway, R. G., Ringel, S. P., Bernat, J. L., Keran, C. M., Lawyer, B. L.
(2000). US neurologists: Attitudes on rationing. Neurology
55: 1492-1497
[Abstract][Full Text]
Sonnenberg, A., Delco, F., Inadomi, J. M.
(2000). Cost-Effectiveness of Colonoscopy in Screening for Colorectal Cancer. ANN INTERN MED
133: 573-584
[Abstract][Full Text]
Schopper, D, Pereira, J, Torres, A, Cuende, N, Alonso, M, Baylin, A, Ammon, C, Rougemont, A
(2000). Estimating the burden of disease in one Swiss canton: what do disability adjusted life years (DALY) tell us?. Int J Epidemiol
29: 871-877
[Abstract][Full Text]
Selmer, R. M, Kristiansen, I. S., Haglerød, A., Graff-Iversen, S., Larsen, H. K, Meyer, H. E, Bønaa, K. H, Thelle, D. S
(2000). Cost and health consequences of reducing the population intake of salt. J. Epidemiol. Community Health
54: 697-702
[Abstract][Full Text]
Neumann, P. J., Stone, P. W., Chapman, R. H., Sandberg, E. A., Bell, C. M.
(2000). The Quality of Reporting in Published Cost-Utility Analyses, 1976-1997. ANN INTERN MED
132: 964-972
[Abstract][Full Text]
Rennie, D., Luft, H. S.
(2000). Pharmacoeconomic Analyses: Making Them Transparent, Making Them Credible. JAMA
283: 2158-2160
[Full Text]
Delco, F, Sonnenberg, A
(2000). A decision analysis of surveillance for colorectal cancer in ulcerative colitis. Gut
46: 500-506
[Abstract][Full Text]
Rubin, G. D., Armerding, M. D., Dake, M. D., Napel, S.
(2000). Cost Identification of Abdominal Aortic Aneurysm Imaging by Using Time and Motion Analyses. Radiology
215: 63-70
[Abstract][Full Text]
Jarvik, J. G., Ramsey, S.
(2000). Radiographic Screening for Orbital Foreign Bodies Prior to MR Imaging: Is It Worth It?. Am. J. Neuroradiol.
21: 245-248
[Full Text]
Seidenwurm, D. J., McDonnell III, C. H., Raghavan, N., Breslau, J.
(2000). Cost Utility Analysis of Radiographic Screening for an Orbital Foreign Body before MR Imaging. Am. J. Neuroradiol.
21: 426-433
[Abstract][Full Text]
Brown, G. C., Brown, M. M., Sharma, S., Tasman, W., Brown, H. C.
(1999). Cost-Effectiveness of Treatment for Threshold Retinopathy of Prematurity. Pediatrics
104: 47e-47
[Abstract][Full Text]
Rich, M. W., Nease, R. F.
(1999). Cost-effectiveness Analysis in Clinical Practice: The Case of Heart Failure. Arch Intern Med
159: 1690-1700
[Abstract][Full Text]
Gross, C. P., Anderson, G. F., Powe, N. R.
(1999). The Relation between Funding by the National Institutes of Health and the Burden of Disease. NEJM
340: 1881-1887
[Abstract][Full Text]
Palmer, S., Byford, S., Raftery, J.
(1999). Economics Notes: Types of economic evaluation. BMJ
318: 1349-1349
[Full Text]
Palmer, S., Torgerson, D. J
(1999). Economics notes: Definitions of efficiency. BMJ
318: 1136-1136
[Full Text]
Alsarraf, R., Jung, C. J., Perkins, J., Crowley, C., Alsarraf, N. W., Gates, G. A.
(1999). Measuring the Indirect and Direct Costs of Acute Otitis Media. Arch Otolaryngol Head Neck Surg
125: 12-18
[Abstract][Full Text]
Russell, L. B.
(1998). Prevention and Medicare Costs. NEJM
339: 1158-1160
[Full Text]
Gage, B. F., Cardinalli, A. B., Owens, D. K.
(1998). Cost-Effectiveness of Preference-Based Antithrombotic Therapy for Patients With Nonvalvular Atrial Fibrillation. Stroke
29: 1083-1091
[Abstract][Full Text]
Edwards, D. M., Shachter, R. D., Owens, D. K.
(1998). A Dynamic HIV-Transmission Model for Evaluating the Costs and Benefits of Vaccine Programs. Interfaces
28: 144-166
[Abstract]
Neumann, P. J.
(1998). Paying the Piper for Pharmacoeconomic Studies. Med Decis Making
18: S23-S26
Blaiss, M. S.
(1997). Outcomes Analysis in Asthma. JAMA
278: 1874-1880
[Abstract]
Sisk, J. E., Moskowitz, A. J., Whang, W., Lin, J. D., Fedson, D. S., McBean, A. M., Plouffe, J. F., Cetron, M. S., Butler, J. C.
(1997). Cost-effectiveness of Vaccination Against Pneumococcal Bacteremia Among Elderly People. JAMA
278: 1333-1339
[Abstract]
Hornberger, J. C., Best, J. H., Garrison, L. P. Jr.
(1997). Cost-Effectiveness of Repeat Medical Procedures: Kidney Transplantation as an Example. Med Decis Making
17: 363-372
[Abstract]
Scharfstein, J. A., Paltiel, A. D., Freedberg, K. A.
(1997). The Cost-Effectiveness of Fluconazole Prophylaxis against Primary Systemic Fungal Infections in AIDS Patients. Med Decis Making
17: 373-381
[Abstract]
Neumann, P. J., Zinner, D. E., Wright, J. C.
(1997). Are Methods for Estimating QALYs in Cost-Effectiveness Analyses Improving?. Med Decis Making
17: 402-408
[Abstract]
Pinkerton, S. D., Holtgrave, D. R., Pinkerton, H. J.
(1997). Cost-effectiveness of Chemoprophylaxis After Occupational Exposure to HIV. Arch Intern Med
157: 1972-1980
[Abstract]
Leplege, A., Hunt, S.
(1997). The Problem of Quality of Life in Medicine. JAMA
278: 47-50
[Abstract]
Fryback, D. G., Lawrence, W. F. JR
(1997). Dollars May Not Buy as Many QALYs as We Think:: A Problem with Defining Quality-of-life Adjustments. Med Decis Making
17: 276-284
[Abstract]
Rosenthal, T. C., James, P., Fox, C., Wysong, J., FitzPatrick, P. G.
(1997). Rural Physicians, Rural Networks, and Free Market Health Care in the 1990s. Arch Fam Med
6: 319-323
[Abstract]
Previous
