Cost-effectiveness analysis for priority setting in health: penny-wise but pound-foolish.
Cost-effectiveness analysis has much conceptual attractiveness in priority setting but is not used to its full potential to assist policy-makers on making choices in health in developed or in developing countries. We call for a shift away from present economic evaluation activities-that tend to produce ad hoc and incomparable economic evaluation studies and, therefore, add little to the compendium of knowledge of cost-effectiveness of health interventions in general-toward a more systematic approach. Research efforts in economic evaluation should build on the foundations of cost-effectiveness research of the past decades to arrive at an informative methodology useful for national policy-makers. This strategy means that governments should steer sectoral cost-effectiveness analysis to obtain systematic and comprehensive information on the economic attractiveness of a set of new and current interventions, using a standardized methodology and capturing interactions between interventions. Without redirecting the focus of economic evaluation research, choosing in health care bears the risk to remain penny-wise but pound-foolish.
Baltussen
Rob
R
Institute for Medical Technology Assessment, Erasmus Medical Centre Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands. r.baltussen@erasmusmc.nl
Brouwer
Werner
W
Niessen
Louis
L
D020811:Biomedical Technology / Q000191:economics; D003362:Cost-Benefit Analysis; D019049:Developed Countries; D003906:Developing Countries; D006291:Health Policy; D006292:Health Priorities / Q000191:economics* / Q000458:organization & administration