The appropriate role of cost-effectiveness in determining device coverage: a case study of drug-eluting stents.
The use of incremental cost-effectiveness ratios based on quality-adjusted life-years (QALYs) as a critical determinant of what should be covered by a health system is a growing trend. This presents challenges when applied to rapidly evolving technologies. The case study here focuses on the example of drug-eluting stents and the four-year change in cost-effectiveness as determined by the U.K. National Institute for Health and Clinical Excellence (NICE). We contend that classic cost-effectiveness as a blunt instrument for determining what should be covered may lead to erroneous conclusions when a broader perspective and the impact on health outcomes and costs are considered.
Firth
Brian Garriock
BG
Cordis Corporation, a Johnson and Johnson subsidiary in Warren, New Jersey, USA.
Cooper
Liesl M
LM
Fearn
Steve
S
D026683:Advisory Committees; D003362:Cost-Benefit Analysis; D054855:Drug-Eluting Stents / Q000191:economics*; D019982:Organizational Case Studies; D019057:Quality-Adjusted Life Years; D012051:Reimbursement Mechanisms; D013222:State Medicine; D006113:United Kingdom