title: Pre-assessment to assess the match between cost-effectiveness results and decision makers' information needs: an illustration using two cases in rehabilitation medicine in The Netherlands.
abstract: OBJECTIVE
  To determine if a pre-assessment can be used to establish whether cost-effectiveness results would meet the actual information needs of Dutch healthcare decision makers.
  
  
  METHODS
  Two recent studies in rehabilitation medicine served as study material. Based on Wholey, a limited pre-assessment was performed in which the potential impact of cost-effectiveness analysis (CEA) results on intended users' decision making was assessed. Desk research and semi-structured interviews with several intended users of CEA results were performed. These included general practitioners, representatives of health insurance companies, the Health Care Insurance Board (CvZ), and medical guidelines committees.
  
  
  RESULTS
  In day-to-day decision making of the interviewed decision makers, a cost-effectiveness criterion seemed to be of limited importance. Instead, results from clinical effectiveness studies and budget impact studies appeared to be sufficient. CvZ, however, preferred relative cost-effectiveness to be a criterion for inclusion in future reimbursement guidelines. In both cases the limited pre-assessments changed the expectations of the investigators regarding decision-making impact of an economic evaluation.
  
  
  CONCLUSIONS
  This study revealed that the use of CEA results for Dutch micro- and meso-level healthcare decision making is not self-evident. The main purpose of CEA results is to support health policy making and planning at a macroeconomic level. Pre-assessment can be a valuable tool in designing a CEA to support the actual information needs of the decision makers.
authors.affiliation: Roessingh Research and Development, Enschede, The Netherlands. m.ijzerman@rrd.nl
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: IJzerman
authors.forename: Robert P B
authors.initials: RP
authors.lastname: Reuzel
authors.forename: Hans L
authors.initials: HL
authors.lastname: Severens
mesh_terms: D022126:Access to Information; D002908:Chronic Disease / Q000191:economics; D003362:Cost-Benefit Analysis; D003659:Decision Making, Organizational; D004599:Electric Stimulation Therapy / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D007348:Insurance, Health; D017116:Low Back Pain / Q000191:economics / Q000534:rehabilitation; D009426:Netherlands; D012656:Self-Help Devices / Q000191:economics; D020521:Stroke / Q000191:economics; D000071939:Stroke Rehabilitation; D013673:Technology Assessment, Biomedical