[How to manage the cost-efficacy ratio?].
The economical science will gradually introduce the health economy of which the definition urges to seek for a better distribution between public and private means to do more and better for the public health. The health market is principally conducted by the supply and demand law. The needs, the supply and demand and the consumer's behaviour are different in this particular market which evolves continuously and progressively goes closer to the market economy. The health status of each human represents the health demand and the medical goods and services are the supply. The role of the valuation studies in health economy is to favour a better use of the limited resources to the unlimited needs. The basic principles of a cost efficacy analysis are relatively simple. They compare the incremental costs with the increase of efficacy. The QALY is built with a combination between life quality and quantity in a unique concept: the measurement of the quality of life of a human at a given moment. The 100th report of the KCE established the restrictions of this method and its absolute use as in England. Indeed we have to take into account other factors as the added value in terms of clinical efficacy, accessibility, the seriousness of pathological cases and the emotional situation. The ICER (Incremental Cost Efficacy Ration) has a lot of weaknesses and may give the illusion that the reimbursement decision is easy. Nevertheless to neglect the economic approach is not ethical. ICER is first of all a balance factor.
De Wever
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Département d'Economie de la Santé, Ecole de Santé Publique, U.L.B., Bruxelles. alain.dewever@ulb.ac.be
D001530:Belgium; D003362:Cost-Benefit Analysis / Q000191:economics / Q000379:methods; D004739:England; D006801:Humans; D011634:Public Health / Q000191:economics* / Q000331:legislation & jurisprudence / Q000592:standards; D011785:Quality Assurance, Health Care