A unique, in-depth discussion of the uses and conduct of cost-effectiveness analyses (CEAs) as decision-making aids in the health and medical fields, Cost-Effectiveness in Health and Medicine is the product of over two years of comprehensive research and deliberation by a multi-disciplinary panel of economists, ethicists, psychometricians, and clinicians. Exploring cost-effectiveness in the context of societal decision-making for resource allocation purposes, this volume proposes that analysts include a "reference-case" analysis in all CEAs designed to inform resource allocation and puts forth the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. Important theoretical and practical issues encountered in measuring costs and effectiveness, evaluating outcomes, discounting, and dealing with uncertainty are examined in separate chapters. Additional chapters on framing and reporting of CEAs elucidate the purpose of the analysis and the effective communication of its findings.
Cost-Effectiveness in Health and Medicine differs from the available literature in several important aspects. Most importantly, it represents a consensus on standard methods. Standardization is particularly important for CEA, since its principal goal, only partly realized to date, is to permit comparisons of the costs and health outcomes of alternative ways of improving health. The second major contribution of this book is the detailed level at which the discussion is offered. Guidelines in journal literature and in CEA-related books tend to be rather general, to the extent that the analyst is left with little guidance on specific matters. Thirdly, this volume is differentiated by a detailed discussion of the theoretical background underlying areas of controversy and the implications of methodological alternatives. Finally, the study is written with a wider audience in mind, since it is not limited , for instance, to pharmaceutical analysts, physicians or any other interest subgroup. Intended primarily for analysts in medicine and public health who wish to improve practice and comparability of CEAs, this book will also be of interest to decision-makers in government, managed care, and industry who wish to consider the roles and limitations of CEA and become familiar with the criteria for evaluating these studies.