Extrapolation of Cost-Effectiveness Information to Local Settings

Author:

Bryan Stirling1,Brown Jackie1

Affiliation:

1. Health Economics Research Group, Brunel University, UK

Abstract

Providers and purchasers of health care are increasingly looking to the results of economic evaluations for guidance when making their decisions. In this paper the authors argue that there are dangers involved in the naive and unthinking use of published cost-effectiveness information outside the setting in which the information was generated. In considering whether the results of a published study are likely to be relevant locally, decision-makers are encouraged to assess whether the values of the key parameters reported in the published study apply locally. The possible sources of variation are described: unit cost differences; differences in the prevalence, incidence or natural history of disease; and differences in the comparators. In situations where the only source of variation is that local unit costs are different, local values can be substituted in the published analysis and local cost-effectiveness results estimated. Where the other sources of variation exist, the decision-maker is required to make an assumption about the nature of the interaction between the sources of variation and the values of the cost-effectiveness parameters. Using an example, the authors argue that local threshold analysis can aid decision-making where the policy change being considered has a high probability either of increasing effectiveness or reducing costs. Without local reanalysis, there is a danger that local policy changes in line with the recommendations of published studies will promote inefficiency. Re-analysis in the local setting is, however, reliant on authors of economic evaluations being explicit about their methods and the comparators used in their analyses.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy

Cited by 42 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3