Incremental cost-effectiveness analysis : The optimal strategy depends on the strategy set.
Evaluating the incremental cost-effectiveness of a technology is critical to understanding the impact of its adoption.
The purpose of this study was to evaluate, using a particular example, how the specific alternatives selected for a cost-effectiveness analysis may influence the results of the analysis.
In this example, we analyzed the incremental cost-effectiveness of estriol screening for Down syndrome.
Model assumptions of expected costs and effectiveness were based on previously published work involving four clinical strategies, including a « do nothing » (no screening) strategy.
When the analysis started with all four strategies, two of the strategies could not be considered cost-effective because of extended dominance.
However, when we eliminated the « do nothing » from the strategy set because of its clinical irrelevance, all three remaining strategies might be considered cost-effective from a policy perspective.
We concluded that the incremental cost-effectiveness of clinical strategies could be strongly affected by the starting point for the analysis.
Mots-clés Pascal : Mongolisme, Nouveau né, Homme, Dépistage, Diagnostic, Prénatal, Analyse coût efficacité, Economie santé, Méthodologie, Amniocentèse, Analyse biochimique, Foetoprotéine alpha, Gonadotrophine, Etats Unis, Amérique du Nord, Amérique, Epidémiologie, Aberration chromosomique, Aneuploïdie, Maladie congénitale, Nouveau né pathologie
Mots-clés Pascal anglais : Down syndrome, Newborn, Human, Medical screening, Diagnosis, Prenatal, Cost efficiency analysis, Health economy, Methodology, Amniocentesis, Biochemical analysis, alpha-Fetoprotein, Gonadotropin, United States, North America, America, Epidemiology, Chromosomal aberration, Aneuploidy, Congenital disease, Newborn diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0393962
Code Inist : 002B20F01. Création : 22/03/2000.