Summary
Economic evaluations are a set of outcomes and health services research methods to inform the debate about the rising cost of health care and include cost-of-illness studies and cost-effectiveness research. Cost-effectiveness research is the comparative analysis of two or more alternative interventions in terms of their health and economic consequences, whose results are expressed as an incremental cost-effectiveness ratio, the ratio of differences in cost between a pair of medical interventions to the differences in the corresponding health effects. These research methods are particularly important to neurological diseases with debilitating natural histories, long-term courses, and a growing number of exciting, yet costly, treatment options available. The results of economic evaluations of neurological conditions influence resource allocation decisions, help set reimbursement rates, estimate future healthcare expenses, and improve the quality and efficiency of delivering neurological care. For these research methods to achieve their potential, continued methodological advances within the field are needed, as well as a more systematic integration of these methods into mainstream research to address critical questions regarding the health and well-being of patients with neurological illness.
Article PDF
Similar content being viewed by others
References
Levit K, Smith C, Cowan C, Sensenig A, Catlin A; Health Accounts Team. Health spending rebound continues in 2002.Health Aff (Millwood) 23: 147–159, 2004.
Smith C. Retail prescription drug spending in the national health accounts.Health Aff (Millwood) 23: 160–167, 2004.
Frank RG. Government commitment and regulation of prescription drugs.Health Aff (Millwood) 22: 46–48, 2003.
Relman AS, Angell M. How the drug industry distorts medicine and politics. America’s other drug problem.New Repub 22–41, 2002.
Starfield B, Weiner J, Mumford L, Steinwachs D. Ambulatory care groups: a categorization of diagnoses for research and management.Health Serv Res 26: 53–74, 1991.
Pollack MM, Ruttimann UE, Getson PR. Pediatric risk of mortal (PRISM) score.Crit Care Med 16: 1110–1116, 1988.
Hughes JS, Iezzoni LI, Daley J, Greenberg L. How severity measures rate hospitalized patients.J Gen Intern Med 11: 303–311, 1996.
State Cardiac Advisory Committee, New York State Department of Health. Coronary Artery Bypass Surgery in New York State 1992–1994. http://www.health.state.ny.us/nysdoh/consumer/heart/ coronary.pdf, 1996.
Cost-effectiveness in health and medicine (Gold MR, Siegel JE, Russell LB, Weinstein MC, eds). New York: Oxford University, 1996.
Torrance GW, Siegel JE, Luce BR. Framing and designing the cost-effectiveness analysis. In: Cost-effectiveness in health and medicine (Gold MR, Siegel JE, Russell LB, Weinstein MC, eds), pp 54–81. New York: Oxford University, 1996.
Ramsey SD, McIntosh M, Sullivan SD. Design issues for conducting cost-effectiveness analyses alongside clinical trials.Annu Rev Public Health 22: 129–141, 2001.
Weinstein MC, O’Brien B, Hornberger J, Jackson J, Johannesson M, McCabe C et al. Principles of good practice for decision analytic modeling in health-care evaluation: report of the ISPOR Task Force on Good Research Practices—Modeling Studies.Value Health 6: 9–17, 2003.
Nuijten MJC. Bridging decision analytic modelling with a cross-sectional study. Application to Parkinson’s disease.Pharmacoeconomics 17: 227–236, 2000.
Ramsey SD, Berry K, Etzioni R, Kaplan RM, Sullivan SD, Wood DE; National Emphysema Treatment Trial Research Group. Cost effectiveness of lung-volume-reduction surgery for patients with severe emphysema.N Engl J Med 348: 2092–2102, 2003.
Davidoff AJ, Powe NR. The role of perspective in defining economic measures for the evaluation of medical technology.Int J Technol Assess Health Care 12: 9–21, 1996.
Goossens ME, Rutten-van Molken MP, Vlaeyen JW, van der Linden SM. The cost diary: a method to measure direct and indirect costs in cost-effectiveness research.J Clin Epidemiol 53: 688–695, 2000.
Luce BR, Elixhauser A. Estimating costs in the economic evaluation of medical technologies.Int J Technol Assess Health Care 6: 57–76, 1990.
Luce BR, Manning WG, Siegel JE, Lipscomb J. Estimating costs in cost-effectiveness analysis. In: Cost-effectiveness in health and medicine (Gold MR, Siegel JE, Russell LB, Weinstein MC, eds), pp 176–213. New York: Oxford University, 1996.
Russell LB. Opportunity costs in modern medicine.Health Aff (Millwood) 11: 162–169, 1992.
Finkler SA. The distinction between cost and charges.Ann Intern Med 96: 102–109, 1982.
Mushlin AI, Hall WJ, Zwanziger J, Gajary E, Andrews M, Marron R et al. The cost-effectiveness of automatic implantable cardiac defibrillators.Circulation 97: 2129–2135, 1998.
2001 Drug Topics Red Book. Montvale, NJ: Medical Economics Company Inc., 2001.
Schulman K, Burke J, Drummond M, Davies L, Carlsson P, Gruger J et al. Resource costing for multinational neurologic clinical trials: methods and results.Health Econ 629–638, 2003.
Diehr P, Yanez D, Ash A, Hornbrook M, Lin DY. Methods for analyzing health care utilization and costs.Annu Rev Public Health 20: 125–144, 1999.
Spitzer JJ. A primer on box-cox estimation.Rev Econ Stat 64: 307–313, 1982.
Duan N, Manning WG, Morris CN, Newhouse JP. Choosing between the sample-selection model and the multi-part model.JBES 2: 283–289, 1984.
Little RJA, Rubin DB. Statistical analysis with missing data. Toronto: Wiley, 1987.
Neumann P, Goldie SJ, Weinstein MC. Preference-based measures in economic evaluation in health care.Annu Rev Public Health 21: 587–611, 2000.
EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group.Health Policy 16: 199–208, 1990.
Kaplan R, Bush JW, Berry CC. Health status: types of validity and the index of well-being.Health Serv Res 11: 478–507, 1976.
Brazier J, Usherwood T, Harper R, Thomas K. Deriving a preference-based single index from the UK SF-36 health survey.J Clin Epidemiol 51: 1115–1128, 1998.
Feeny D, Furlong W, Barr RD. A comprehensive multiattribute system for classifying the health status of survivors of childhood cancer.J Clin Oncol 10: 923–928, 1992.
Lenert L, Kaplan R. Validity and interpretation of preference-based measures of health-related quality of life.Med Care 38: II138-II150, 2000.
Lipscomb J, Weinstein MC, Torrance GW. Time preference. In: Cost-effectiveness in health and medicine, (Gold MR, Siegel JE, Russell LB, Weinstein MC, eds), pp 214–246. New York: Oxford University, 1996.
Briggs AH. A Bayesian approach to stochastic cost-effectiveness analysis. An illustration and application to blood pressure control in type 2 diabetes.Int J Technol Assess Health Care 17: 69–82, 2001.
Hoch JS, Briggs AH, Willan AR. Something old, something new, something borrowed, something blue: a framework for the marriage of health econometrics and cost-effectiveness analysis.Health Econ 11: 415–430, 2002.
Efron B, Tibshirani R. Bootstrap measures of standard errors, confidence intervals, and other measures of statistical accuracy.Stat Sci 1: 54–77, 1986.
Fenwick E, Claxton K, Sculpher M. Representing uncertainty: the role of cost-effectivess acceptability curves.Health Econ 779–787, 2003.
Ubel PA, Hirth RA, Chernew ME, Fendrick A. What is the price of life and why doesn’t it increase at the rate of inflation?Arch Intern Med 163: 1637–1641, 2003.
Weinstein MC, Toy EL, Sandberg E, Neumann PJ, Evans JS, Kuntz KM et al. Modeling for health care and other policy decisions: uses, roles, and validity.Value Health 4: 348–361, 2001.
Baker CB, Johnsrud MT, Crimson ML, Rosenheck RA, Woods SW. Quantitative analysis of sponsorship bias in economic studies of antidepressants.Br J Psychiatry 183: 498–506, 2003.
Drummond MF, Richardson WS, O’Brien BJ, Levine M, Heyland D. Users’ guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice A. Are the results of the study valid? Evidence-Based Medicine Working Group.JAMA 277: 1552–1557, 1997.
O’Brien BJ, Heyland D, Richardson WS, Levine M, Drummond MF. Users’ guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice B. What are the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group.JAMA 277: 1802–1806, 1997.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Noyes, K., Holloway, R.G. Evidence from cost-effectiveness research. Neurotherapeutics 1, 348–355 (2004). https://doi.org/10.1602/neurorx.1.3.348
Issue Date:
DOI: https://doi.org/10.1602/neurorx.1.3.348