This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Cohen, D. J. Articles by Reynolds, M. R. Search for Related Content PubMed PubMed Citation Articles by Cohen, D. J. Articles by Reynolds, M. R. Related Collections Related Article

STATE-OF-THE-ART PAPER

Interpreting the Results of Cost-Effectiveness Studies

David J. Cohen, MD, MSc, FACC^_*,_* and Matthew R. Reynolds, MD, MSc, FACC

^_* Saint Luke's Mid America Heart Institute, Kansas City, Missouri
Beth Israel Deaconess Medical Center, Harvard Clinical Research Institute, Boston, Massachusetts

Manuscript received July 22, 2008; revised manuscript received September 2, 2008, accepted September 29, 2008.

^_* Reprint requests and correspondence: Dr. David. J. Cohen, Saint Luke's Mid America Heart Institute, 4401 Wornall Road, Kansas City, Missouri 64111 (Email: dcohen{at}saint-lukes.org).

In developed nations, health care spending is an increasingly important economic and political issue. The discipline of cost-effectiveness (CE) analysis has developed over several decades as a tool for objectively assessing the value of new medical strategies, by simultaneously examining incremental health benefits in light of incremental costs. The underlying goal of CE research is to allow clinicians and policymakers to make more rational decisions regarding clinical care and resource allocation. This review will provide the reader with an understanding of the theoretical underpinnings of CE analysis, the types of analyses commonly performed and reported in the medical literature, some important strengths and weaknesses of different analytical approaches, and key principles in the interpretation of CE results. Key principles reviewed include the impact of analytic perspective, the importance of proper incremental comparisons, the effect of time horizon, and methods for exploring and describing uncertainty. Illustrative examples from the cardiology literature are discussed.

Key Words: costs • cost-effectiveness • quality of life

Abbreviations and Acronyms   CE = cost-effectiveness   CRT-D = cardiac resynchronization therapy defibrillator   CRT-P = cardiac resynchronization therapy pacemaker   DES = drug-eluting stent(s)   iCER = incremental cost-effectiveness ratio   QALY = quality-adjusted life year

Related Article

Inside This Issue of JACC
J. Am. Coll. Cardiol. 2008 52: A29. [Full Text] [PDF]

This article has been cited by other articles:

				W. F. Fearon, B. Bornschein, P. A. L. Tonino, R. M. Gothe, B. D. Bruyne, N. H. J. Pijls, U. Siebert, and for the Fractional Flow Reserve Versus Angiography Economic Evaluation of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease Circulation, December 14, 2010; 122(24): 2545 - 2550. [Abstract] [Full Text] [PDF]

				N. Graves, S. Harbarth, J. Beyersmann, A. Barnett, K. Halton, and B. Cooper Estimating the Cost of Health Care-Associated Infections: Mind Your p's and q's Clinical Infectious Diseases, April 1, 2010; 50(7): 1017 - 1021. [Abstract] [Full Text] [PDF]