Cost-effectiveness league tables
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This paper asks the question ‘are cost-effectiveness league tables a good way to provide information to decision makers about the value of new healthcare interventions?’ League tables that rank alternative healthcare interventions based on their incremental cost-effectiveness ratios (ICERs) are seen by economists as a valuable tool to inform decision makers about the allocation of scarce healthcare resources. However, league tables frequently compare ICERs from studies that have computed these ratios using different methods and assumptions including choice of comparator, choice of discount rate, time horizon, and population subgroup. The methodological differences among studies may influence the ranking of the studies and therefore decisions made using the league table. In addition, league tables generally do not include measures of the uncertainty of the cost-effectiveness estimates. In this paper, a reference case approach is proposed for the computation of the incremental cost-effectiveness ratio and an expanded set of measures is proposed for inclusion in the league table. In addition, a central repository for reference case expanded league tables is suggested so that decision makers can use them more effectively and more consistently.
KeywordsDecision Maker Incremental Cost Contingent Valuation League Table QALY Gain
No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript. The manuscript was based on an issues panel presentation by the authors at the Fourth Annual European Congress of ISPOR, November 2001.
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