Representing uncertainty: the role of cost-effectiveness acceptability curves.
Decision-making in health care is inevitably undertaken in a context of uncertainty concerning the effectiveness and costs of health care interventions and programmes. One method that has been suggested to represent this uncertainty is the cost-effectiveness acceptability curve. This technique, which directly addresses the decision-making problem, has advantages over confidence interval estimation for incremental cost-effectiveness ratios. However, despite these advantages, cost-effectiveness acceptability curves have yet to be widely adopted within the field of economic evaluation of health care technologies. In this paper we consider the relationship between cost-effectiveness acceptability curves and decision-making in health care, suggest the introduction of a new concept more relevant to decision-making, that of the cost-effectiveness frontier, and clarify the use of these techniques when considering decisions involving multiple interventions. We hope that as a result we can encourage the greater use of these techniques.
Fenwick
E
E
Centre for Health Economics, University of York, York, UK. ealf100@york.ac.uk
Claxton
K
K
Sculpher
M
M
D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D003627:Data Interpretation, Statistical; D003657:Decision Making; D006801:Humans; D017059:Models, Econometric; D019057:Quality-Adjusted Life Years; D013673:Technology Assessment, Biomedical / Q000191:economics / Q000379:methods*