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Medline ® Abstracts for References 2-7

of 'A short primer on cost-effectiveness analysis'

2
TI
Clinical economics. A guide to the economic analysis of clinical practices.
AU
Eisenberg JM
SO
JAMA. 1989;262(20):2879.
 
AD
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
PMID
3
TI
A clinician's guide to cost-effectiveness analysis.
AU
Detsky AS, Naglie IG
SO
Ann Intern Med. 1990;113(2):147.
 
Cost-effectiveness analysis can be used to help set priorities for funding health care programs. For each intervention, the costs and clinical outcomes associated with that strategy must be compared with an alternate strategy for treating the same patients. If an intervention results in improved outcomes but also costs more, the incremental cost per incremental unit of clinical outcome should be calculated. The incremental cost-effectiveness ratios for various programs can be ranked to set funding priorities. By using this list, the person responsible for allocating resources can maximize the net health benefit for a target population derived from a fixed budget. Clinicians may not share this objective because, individually, they are appropriately concerned solely with the effectiveness of a specific intervention for their patients and are not concerned with the benefit derived from spending those resources on other patients in the target population. In addition, allocation may be driven by distributional and political objectives. Nevertheless, cost-effectiveness analysis demonstrates the consequences of allocation decisions. Because clinicians should participate in policy making, they must understand d the role of this technique in setting funding priorities.
AD
Division of General Internal Medicine and Clinical Epidemiology, Toronto General Hospital, Ontario.
PMID
4
TI
Cost-effectiveness: definitions and use in the gastroenterology literature.
AU
Provenzale D, Lipscomb J
SO
Am J Gastroenterol. 1996;91(8):1488.
 
UNLABELLED: In this era of rapid change in our health care system, we will be required to demonstrate that our practices and procedures in gastroenterology are both effective and cost-effective. In the face of rising national health care expenditures, the medical profession confronts an increased demand to justify practices and to demonstrate the value of its services. This has led to both an expansive literature examining the cost-effectiveness of practices and procedures and an alarming disparity in the definition and use of the term "cost-effectiveness." Many reports may be lacking appropriate documentation of costs and benefits, the critical components for the determination of cost-effectiveness.
OBJECTIVE: The purpose of this article was to define what is meant by a "cost-effective" intervention, with special reference to gastroenterology.
METHODS: The varied use of the term "cost-effective" in the gastroenterology literature is illustrated. Accepted definitions of the term are provided, and suggested uses are outlined. The value judgements that must be made in funding decisions are presented, and the parameters that may be used to determine the cost-effectiveness of a procedure or practice are discussed.
SUMMARY: Cost-effectiveness as it applies to GI medicine is defined, and appropriate and inappropriate uses of the term are illustrated. It is only through effective communication and precise definitions that we will be able to determine the cost-effectiveness of our practices in gastroenterology.
AD
Division of Gastroenterology, Sanford Institute of Public Policy, Durham, NC, USA.
PMID
5
TI
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.
AU
Drummond MF, Richardson WS, O'Brien BJ, Levine M, Heyland D
SO
JAMA. 1997;277(19):1552.
 
AD
Centre for Health Economics, University of York, England.
PMID
6
TI
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.
AU
O'Brien BJ, Heyland D, Richardson WS, Levine M, Drummond MF
SO
JAMA. 1997;277(22):1802.
 
AD
Department of Clinical Epidemiology and Biostatistics, McMaster University, St Joseph's Hospital, Hamilton, Ontario, Canada.
PMID
7
TI
Information on cost-effectiveness: an essential product of a national comparative effectiveness program.
AU
American College of Physicians
SO
Ann Intern Med. 2008;148(12):956.
 
The American College of Physicians recently highlighted the need to provide increased information comparing the effectiveness of health care interventions to ensure the rational and effective practice of medicine. Comparative effectiveness refers to the evaluation of the relative clinical effectiveness, safety, and cost of 2 or more medical services, drugs, devices, therapies, or procedures used to treat the same condition. The College further recommended the establishment of an adequately funded, trusted national entity that should prioritize, sponsor, or produce both comparative clinical and cost-effectiveness data. This article addresses the need for the proposed entity to develop cost-effectiveness information. It examines the current reluctance to develop and use cost-effectiveness in the United States; it argues for the importance of this information for all health care stakeholders; and it makes specific recommendations regarding how this information can best be made available and used for the good of the public and our patients.
AD
PMID