Extrapolation of cost-effectiveness information to local settings.
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. (...)
Mots-clés Pascal : Analyse coût efficacité, Sciences économiques, Prévalence, Epidémiologie, Variable, Incidence, Méthodologie, Microéconomie, Santé, Indicateur, Morbidité, Aide décision, Etat sanitaire, Mesure
Mots-clés Pascal anglais : Cost efficiency analysis, Economics, Prevalence, Epidemiology, Variable, Incidence, Methodology, Microeconomy, Health, Indicator, Morbidity, Decision aid, Health status, Measurement
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 11/09/1998.