IDEAS home Printed from https://ideas.repec.org/a/eee/ejores/v204y2010i1p180-187.html
   My bibliography  Save this article

Optimal healthcare decisions: Comparing medical treatments on a cost-effectiveness basis

Author

Listed:
  • Moreno, Elías
  • Girón, F.J.
  • Vázquez-Polo, F.J.
  • NegrI´n, M.A.

Abstract

This paper deals with medical treatments comparison from the cost-effectiveness viewpoint. A decision theory scheme is considered, where the decision space is the set of treatments involved, the space of states of nature consists of the respective net benefits of the treatments, and the utility function is one of two possible candidates. A first candidate is the one typically used in the literature on cost-effectiveness analysis, for which the utility of a decision is proportional to the net benefit gain, and a second one is of the type 0-1, which penalizes the wrong decisions with a fixed quantity. Their associated optimal decision rules, both frequentist and Bayesian, are analyzed and compared via frequentist evaluation of their performance, and the conclusion is that the latter beats the former in the sense of choosing the optimal treatment more often than any other, thus minimizing the proportion of wrong decisions. Illustrations with simulated and real data are provided.

Suggested Citation

  • Moreno, Elías & Girón, F.J. & Vázquez-Polo, F.J. & NegrI´n, M.A., 2010. "Optimal healthcare decisions: Comparing medical treatments on a cost-effectiveness basis," European Journal of Operational Research, Elsevier, vol. 204(1), pages 180-187, July.
    • Handle: RePEc:eee:ejores:v:204:y:2010:i:1:p:180-187
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0377-2217(09)00756-5
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Andrew R. Willan & Matthew E. Kowgier, 2008. "Cost‐effectiveness analysis of a multinational RCT with a binary measure of effectiveness and an interacting covariate," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 777-791, July.
    3. Karl Claxton & Larry F. Lacey & Stephen G. Walker, 2000. "Selecting treatments: a decision theoretic approach," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 163(2), pages 211-225.
    4. Daniel F. Heitjan & Huiling Li, 2004. "Bayesian estimation of cost‐effectiveness: an importance‐sampling approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 191-198, February.
    5. Maiwenn J. Al & Ben A. Van Hout, 2000. "A Bayesian approach to economic analyses of clinical trials: the case of stenting versus balloon angioplasty," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 599-609, October.
    6. Simon G. Thompson & Richard M. Nixon, 2005. "How Sensitive Are Cost-Effectiveness Analyses to Choice of Parametric Distributions?," Medical Decision Making, , vol. 25(4), pages 416-423, July.
    7. David J. Vanness & John Mullahy, 2006. "Perspectives on Mean-based Evaluation of Health Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, chapter 49, Edward Elgar Publishing.
    8. Francisco-José Polo & Miguel Negrín & Xavier Badía & Montse Roset, 2005. "Bayesian regression models for cost-effectiveness analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 45-52, March.
    9. Chalabi, Zaid & Epstein, David & McKenna, Claire & Claxton, Karl, 2008. "Uncertainty and value of information when allocating resources within and between healthcare programmes," European Journal of Operational Research, Elsevier, vol. 191(2), pages 530-539, December.
    10. Anthony O'Hagan & John W. Stevens, 2001. "A framework for cost‐effectiveness analysis from clinical trial data," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 303-315, June.
    11. Brailsford, Sally & Harper, Paul, 2008. "OR in Health," European Journal of Operational Research, Elsevier, vol. 185(3), pages 901-904, March.
    12. Andrew M. Jones (ed.), 2006. "The Elgar Companion to Health Economics," Books, Edward Elgar Publishing, number 3572.
    13. Weinstein, Milton C. & Manning, Willard Jr., 1997. "Theoretical issues in cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 121-128, February.
    14. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis," NBER Technical Working Papers 0227, National Bureau of Economic Research, Inc.
    15. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits," Medical Decision Making, , vol. 18(2_suppl), pages 68-80, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Simon Eckermann & Andrew Willan, 2011. "Presenting Evidence and Summary Measures to Best Inform Societal Decisions When Comparing Multiple Strategies," PharmacoEconomics, Springer, vol. 29(7), pages 563-577, July.
    2. Michał Jakubczyk & Bogumił Kamiński, 2017. "Fuzzy approach to decision analysis with multiple criteria and uncertainty in health technology assessment," Annals of Operations Research, Springer, vol. 251(1), pages 301-324, April.
    3. Musal, R. Muzaffer & Soyer, Refik & McCabe, Christopher & Kharroubi, Samer A., 2012. "Estimating the population utility function: A parametric Bayesian approach," European Journal of Operational Research, Elsevier, vol. 218(2), pages 538-547.
    4. Moreno, E. & Girón, F.J. & Martínez, M.L. & Vázquez-Polo, F.J. & Negrín, M.A., 2013. "Optimal treatments in cost-effectiveness analysis in the presence of covariates: Improving patient subgroup definition," European Journal of Operational Research, Elsevier, vol. 226(1), pages 173-182.
    5. Moreno, Elías & Girón, F.J. & Vázquez-Polo, F.J. & Negrín, M.A., 2012. "Optimal healthcare decisions: The importance of the covariates in cost–effectiveness analysis," European Journal of Operational Research, Elsevier, vol. 218(2), pages 512-522.
    6. Chen, Ting-Yu & Chang, Chien-Hung & Rachel Lu, Jui-fen, 2013. "The extended QUALIFLEX method for multiple criteria decision analysis based on interval type-2 fuzzy sets and applications to medical decision making," European Journal of Operational Research, Elsevier, vol. 226(3), pages 615-625.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Moreno, Elías & Girón, F.J. & Vázquez-Polo, F.J. & Negrín, M.A., 2012. "Optimal healthcare decisions: The importance of the covariates in cost–effectiveness analysis," European Journal of Operational Research, Elsevier, vol. 218(2), pages 512-522.
    2. Caterina Conigliani & Andrea Tancredi, 2009. "A Bayesian model averaging approach for cost‐effectiveness analyses," Health Economics, John Wiley & Sons, Ltd., vol. 18(7), pages 807-821, July.
    3. Moreno, E. & Girón, F.J. & Martínez, M.L. & Vázquez-Polo, F.J. & Negrín, M.A., 2013. "Optimal treatments in cost-effectiveness analysis in the presence of covariates: Improving patient subgroup definition," European Journal of Operational Research, Elsevier, vol. 226(1), pages 173-182.
    4. Hoch, Jeffrey S. & Blume, Jeffrey D., 2008. "Measuring and illustrating statistical evidence in a cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 27(2), pages 476-495, March.
    5. Simon Eckermann & Tim Coelli, 2008. "Including quality attributes in a model of health care efficiency: A net benefit approach," CEPA Working Papers Series WP032008, School of Economics, University of Queensland, Australia.
    6. Emma McIntosh, 2006. "Using Discrete Choice Experiments within a Cost-Benefit Analysis Framework," PharmacoEconomics, Springer, vol. 24(9), pages 855-868, September.
    7. Helen Dakin & Sarah Wordsworth, 2013. "Cost‐Minimisation Analysis Versus Cost‐Effectiveness Analysis, Revisited," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 22-34, January.
    8. Stefano Conti & Karl Claxton, 2008. "Dimensions of design space: a decision-theoretic approach to optimal research design," Working Papers 038cherp, Centre for Health Economics, University of York.
    9. Richard M. Nixon & David Wonderling & Richard D. Grieve, 2010. "Non‐parametric methods for cost‐effectiveness analysis: the central limit theorem and the bootstrap compared," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 316-333, March.
    10. Eckermann, Simon & Coelli, Tim, 2013. "Including quality attributes in efficiency measures consistent with net benefit: Creating incentives for evidence based medicine in practice," Social Science & Medicine, Elsevier, vol. 76(C), pages 159-168.
    11. Daniel F. Heitjan & Huiling Li, 2004. "Bayesian estimation of cost‐effectiveness: an importance‐sampling approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 191-198, February.
    12. Francisco-José Polo & Miguel Negrín & Xavier Badía & Montse Roset, 2005. "Bayesian regression models for cost-effectiveness analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 45-52, March.
    13. Richard M. Nixon & Simon G. Thompson, 2005. "Methods for incorporating covariate adjustment, subgroup analysis and between‐centre differences into cost‐effectiveness evaluations," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1217-1229, December.
    14. Bebu, Ionut & Luta, George & Mathew, Thomas & Kennedy, Paul A. & Agan, Brian K., 2016. "Parametric cost-effectiveness inference with skewed data," Computational Statistics & Data Analysis, Elsevier, vol. 94(C), pages 210-220.
    15. Casey Quinn, 2005. "Generalisable regression methods for costeffectiveness using copulas," Health, Econometrics and Data Group (HEDG) Working Papers 05/13, HEDG, c/o Department of Economics, University of York.
    16. Lynch, Frances L. & Dickerson, John F. & Pears, Katherine C. & Fisher, Philip A., 2017. "Cost effectiveness of a school readiness intervention for foster children," Children and Youth Services Review, Elsevier, vol. 81(C), pages 63-71.
    17. Basu, Anirban, 2011. "Economics of individualization in comparative effectiveness research and a basis for a patient-centered health care," Journal of Health Economics, Elsevier, vol. 30(3), pages 549-559, May.
    18. Nikki McCaffrey & Meera Agar & Janeane Harlum & Jonathon Karnon & David Currow & Simon Eckermann, 2015. "Better Informing Decision Making with Multiple Outcomes Cost-Effectiveness Analysis under Uncertainty in Cost-Disutility Space," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-19, March.
    19. Nicola E Stanczyk & Eline S Smit & Daniela N Schulz & Hein de Vries & Catherine Bolman & Jean W M Muris & Silvia M A A Evers, 2014. "An Economic Evaluation of a Video- and Text-Based Computer-Tailored Intervention for Smoking Cessation: A Cost-Effectiveness and Cost-Utility Analysis of a Randomized Controlled Trial," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-14, October.
    20. Falk Schwendicke & Hendrik Meyer-Lueckel & Michael Stolpe & Christof Edmund Dörfer & Sebastian Paris, 2014. "Costs and Effectiveness of Treatment Alternatives for Proximal Caries Lesions," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-10, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:ejores:v:204:y:2010:i:1:p:180-187. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/eor .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.