Costs in Comparative Effectiveness Research

Abstract

The chapter brings together discussions of quality in health care and comparative effectiveness research (CER). The backdrop to this chapter is the search for the highest quality of care in the health system. The specific question addressed is: can the goals of CER (i.e., evidence-informed decision-making to improve health-care quality) be achieved for all potential users of CER information (i.e., patients, clinicians, purchasers, and policy-makers) without information on costs? The finding is that CER can be undertaken effectively as a discrete activity without explicit consideration of costs. However, the broader goals of actors within the health-care system (i.e., “to improve health care at both the individual and population levels”) require information on CER as one input, but alone CER is insufficient. The goals for all groups of actors cannot be met without explicit consideration of costs. This is true for all potential users of CER information although the perspective of cost information required by each stakeholder group, not surprisingly, varies. Therefore, the contention is that CER, when coupled with information about cost, provides useful direction in creating high-quality care at the individual and population levels.