Estimation of the incremental cost-effectiveness ratio (ICER) is difficult for several reasons: treatments that decrease both cost and effectiveness and treatments that increase both cost and effectiveness can yield identical values of the ICER; the ICER is a discontinuous function of the mean diffe
The usefulness of average cost-effectiveness ratios
β Scribed by Eugene M. Laska; Morris Meisner; Carole Siegel
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 82 KB
- Volume
- 6
- Category
- Article
- ISSN
- 1057-9230
No coin nor oath required. For personal study only.
β¦ Synopsis
We demonstrate that average cost-effectiveness ratios (CERs) play an important role in the evaluation of the cost-effectiveness of treatments. Criticisms of the usefulness of CERs derive mostly from the context of resource allocation under a constrained budget in which some decisions are based on incremental CERs. However, we show that in many cases, these decision rules are equivalent to decision rules on CERs. This follows for mutually exclusive treatments first, because a treatment is eliminated by extended dominance if and only if there is a mixed treatment with a smaller CER, where the mixing parameter lies in a certain interval. Second, after elimination of treatments by dominance and by extended dominance, resources can be allocated in order of increasing CERs. Moreover, the CER is a parameter that characterizes clinical and economical properties of a treatment independent of its comparators.
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