[Bayesian approach for the cost-effectiveness evaluation of healthcare technologies].
The development of Bayesian statistical methods for the assessment of the cost-effectiveness of health care technologies is reviewed. Although many studies adopt a frequentist approach, several authors have advocated the use of Bayesian methods in health economics. Emphasis has been placed on the advantages of the Bayesian approach, which include: (i) the ability to make more intuitive and meaningful inferences; (ii) the ability to tackle complex problems, such as allowing for the inclusion of patients who generate no cost, thanks to the availability of powerful computational algorithms; (iii) the importance of a full use of quantitative and structural prior information to produce realistic inferences. Much literature comparing the cost-effectiveness of two treatments is based on the incremental cost-effectiveness ratio. However, new methods are arising with the purpose of decision making. These methods are based on a net benefits approach. In the present context, the cost-effectiveness acceptability curves have been pointed out to be intrinsically Bayesian in their formulation. They plot the probability of a positive net benefit against the threshold cost of a unit increase in efficacy.A case study is presented in order to illustrate the Bayesian statistics in the cost-effectiveness analysis. Emphasis is placed on the cost-effectiveness acceptability curves. Advantages and disadvantages of the method described in this paper have been compared to frequentist methods and discussed.
Dipartimento di sanità pubblica e microbiologia, Università di Torino, Via Santena 5bis, 10126 Torino, Italy. paola.berchialla@unito.it
Paola
P
Berchialla
Dario
D
Gregori
Franco
F
Brunello
Andrea
A
Veltri
Michele
M
Petrinco
Eva
E
Pagano
D001499:Bayes Theorem; D020811:Biomedical Technology / Q000191:economics*; D003362:Cost-Benefit Analysis