Opportunity costs and uncertainty in the economic evaluation of health care interventions.
Considerable methodological research has been conducted on handling uncertainty in cost-effectiveness analysis. The current literature suggests the concepts of net health benefits and cost-effectiveness acceptability curves to circumvent the technical shortcomings of cost-effectiveness ratio statistics. However, these approaches do not provide a solution for the inherent problem that the threshold cost-effectiveness ratio itself is unknown. The authors suggest analysing uncertainty in cost-effectiveness analysis by directly addressing the concept of opportunity costs using the decision rule described by Birch and Gafni (1992) and introduce a new graphical framework (the "decision making plane") for communicating with policy makers.
Sendi
P
P
Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5.
Gafni
A
A
Birch
S
S
D002017:Budgets; D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000379:methods / Q000706:statistics & numerical data*; D003659:Decision Making, Organizational; D015658:HIV Infections / Q000191:economics / Q000628:therapy; D017048:Health Care Costs; D015276:Health Care Rationing / Q000191:economics* / Q000379:methods; D006801:Humans; D017059:Models, Econometric; D011050:Policy Making; D015397:Program Evaluation / Q000191:economics / Q000379:methods