Cost-utility analysis from a societal perspective

Johannesson, Magnus; O‘Conor, Richard M.

doi:10.1016/s0168-8510(96)00878-0

Cited by 42 publications

(36 citation statements)

References 18 publications

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“…Such criteria do not exist for cost-effectiveness and cost-utility analysis [16,17]. These analyses can only be used to rank interventions and choose the ones that lead to the maximum health gain under a restricted budget.…”

Section: Decision Rulesmentioning

confidence: 99%

“…To effectively use cost-effectiveness or cost-utility analysis as a method for maximization of the units of health gained for a given budget or related to WTP per unit of health gained, one has to formally derive or define what is considered cost-effective [17]. As a threshold, either the implied cut-off by the maximum budget can be used or the maximum WTP per unit of health gain.…”

Section: Decision Rulesmentioning

confidence: 99%

“…The former requires a detailed insight in the actual budget. Additionally, only those costs that actually fall into the budget should be included in the pharmacoeconomic analysis [17]. Obviously, this leads to yet another methodological inconsistency, since using the societal perspective implies including all costs (inclusive indirect and patientborne) and not only those that fall in the specific budget [16].…”

Section: Decision Rulesmentioning

confidence: 99%

“…Obviously, this leads to yet another methodological inconsistency, since using the societal perspective implies including all costs (inclusive indirect and patientborne) and not only those that fall in the specific budget [16]. Therefore, as Johannesson and O'Conor highlight in their paper, cost-utility analysis based on a fixed budget will not be consistent with using a societal perspective [17]. Alternatively, the maximum WTP per unit of health gain could be defined as the rule for decision making.…”

Section: Decision Rulesmentioning

confidence: 99%

“…This means that the WTP per QALY should be based on the marginal utility of income of the financiers of the health program [17]. Since a multitude of budgets exists and projects are often funded from multiple budgets, the marginal utility of income of the financier will depend on the intervention and manner in which it is financed.…”

Section: Willingness To Paymentioning

confidence: 99%

See 4 more Smart Citations

Using pharmacoeconomics for policy making: is rational decision making enhanced by applying thresholds for cost-effectiveness?

Bos

Postma

2004

Expert Review of Pharmacoeconomics & Outcomes Research

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Section: Decision Rulesmentioning

confidence: 99%

Section: Decision Rulesmentioning

confidence: 99%

Section: Decision Rulesmentioning

confidence: 99%

Section: Decision Rulesmentioning

confidence: 99%

Section: Willingness To Paymentioning

confidence: 99%

See 3 more Smart Citations

Using pharmacoeconomics for policy making: is rational decision making enhanced by applying thresholds for cost-effectiveness?

Bos

Postma

2004

Expert Review of Pharmacoeconomics & Outcomes Research

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The cost-effectiveness of preference-based treatment allocation: the case of hysterectomy versus endometrial resection in the treatment of menorrhagia

Sculpher

1998

Health Econ.

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Typically, economic evaluation compares the costs and benefits of two or more interventions and seeks to identify the single superior option on the basis of relative cost-effectiveness. It is then anticipated that all patients will receive the more or most cost-effective option. This 'all or nothing' approach can be departed from when sub-groups of patient exist, defined on the basis of clinical or demographic characteristics which are considered to influence benefit, for whom an option is cost-effective whilst not being so for the population of patients as a whole. However, patients' preferences concerning the different process characteristics and outcomes of an intervention will also influence the benefit they derive from health care. This paper explores the concept of preference-based sub-group analysis in economic evaluation to assess the potential cost-effectiveness of using patients' preferences to determine treatment allocation. The clinical example used to explore these methods is the comparison of abdominal hysterectomy (AH) and transcervical resection of the endometrial (TCRE) for the treatment of menorrhagia.

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Towards the equitably efficient and transparently decidable use of public funds in the deep blue millennium

Dowie

1998

Health Econ.

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Health economists concerned about the efficiency and equity of health care provision have focused their attention and evaluations on programmes and interventions at a population or group level. Clinicians, including those seeking to improve the quality of care by making it more evidence-based, see their task as using their clinical judgment to make the best use of the resources available to them as a result of policy decisions The existence of significant incoherence between the two (or more) levels is increasingly recognized, but clinical guidelines, the only current response, are analytically inadequate to the task of reducing it. 'Clinical Guidance Trees', on the other hand, not only have the potential to bridge the policy-clinical gap but also provide the means by which public funds can be allocated to individual patients on the basis of a societally determined willingness to pay per incremental unit of benefit. This paper aims to stimulate debate about a system in which all public funds are allocated on the basis of patient specific cost-effectiveness analyses, conducted on the basis of sociopolitically determined parameters (including equity weightings), but individualized 'quality of life' measures. The system, seeking to maximize 'equificiency', would do away with the increasingly unsustainable division between public and private sector provision and remove many expensive layers of health care decision making. While it would have many problems (including strategic behaviour various by parties), these need to be considered in the light of the problems of all alternative systems, including those of the status quo.

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Cost-utility analysis from a societal perspective

Cited by 42 publications

References 18 publications

Using pharmacoeconomics for policy making: is rational decision making enhanced by applying thresholds for cost-effectiveness?

Using pharmacoeconomics for policy making: is rational decision making enhanced by applying thresholds for cost-effectiveness?

The cost-effectiveness of preference-based treatment allocation: the case of hysterectomy versus endometrial resection in the treatment of menorrhagia

Towards the equitably efficient and transparently decidable use of public funds in the deep blue millennium

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