IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v28y2008i2p172-181.html
   My bibliography  Save this article

Health Technology Assessment in the Cost-Disutility Plane

Author

Listed:
  • Simon Eckermann

    (Flinders Centre for Clinical Change and Health Care Research, Flinders University, Adelaide, Australia, simon.eckermann@flinders.edu.au)

  • Andrew Briggs
  • Andrew R. Willan

    (SickKids Research Institute and University of Toronto, Ontario, Canada)

Abstract

Previously, comparisons of multiple strategies in health technology assessment have been undertaken on the incremental cost-effectiveness plane using efficiency frontiers and cost-effectiveness acceptability curves. This article proposes shifting the comparison of multiple strategies to the cost-disutility plane. Evidence-based decision making requires comparison of all strategies against each other. Consequently, the origin in the incremental cost-effectiveness plane cannot be the appropriate reference point in comparing multiple nondominated strategies. A linear transformation onto the cost-disutility plane allows an equivalent comparison of net benefit and permits the use of standard efficiency measurement methods to estimate 1) the degree of dominance (technical inefficiency) of dominated strategies and 2) the net benefit inefficiency (i.e., losses in net benefit relative to an optimal strategy). In comparing strategies under uncertainty, a comparison of loss in net benefit leads to the expected net loss frontier, which, unlike cost effectiveness acceptability curves, directly identifies differences in expected net benefit (net loss) and the expected value of perfect information. Thus, decision makers can be better informed about the choice of optimal strategy and the potential value of future research to resolve uncertainty. Comparing strategies in the cost-disutility plane is suggested to better inform decision making and to provide a link between the cost-effectiveness literature and efficiency measurement methods.

Suggested Citation

  • Simon Eckermann & Andrew Briggs & Andrew R. Willan, 2008. "Health Technology Assessment in the Cost-Disutility Plane," Medical Decision Making, , vol. 28(2), pages 172-181, March.
    • Handle: RePEc:sae:medema:v:28:y:2008:i:2:p:172-181
    DOI: 10.1177/0272989X07312474
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X07312474
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X07312474?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2001. "Representing uncertainty: the role of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 779-787, December.
    2. Aaron A. Stinnett & A. David Paltiel, 1997. "Estimating CE Ratios under Second-order Uncertainty," Medical Decision Making, , vol. 17(4), pages 483-489, October.
    3. Karl Claxton & John Posnett, "undated". "An Economic Approach to Clinical Trial Design and Research Priority Setting," Discussion Papers 96/19, Department of Economics, University of York.
    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. 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.
    3. 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.
    4. Simon Eckermann & Andrew R. Willan, 2009. "Globally optimal trial design for local decision making," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 203-216, February.

    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. Karl Claxton & Elisabeth Fenwick & Mark J. Sculpher, 2012. "Decision-making with Uncertainty: The Value of Information," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 51, Edward Elgar Publishing.
    2. Neil Hawkins & Mark Sculpher & David Epstein, 2005. "Cost-Effectiveness Analysis of Treatments for Chronic Disease: Using R to Incorporate Time Dependency of Treatment Response," Medical Decision Making, , vol. 25(5), pages 511-519, September.
    3. J. Brown & N. J. Welton & C. Bankhead & S. H. Richards & L. Roberts & C. Tydeman & T. J. Peters, 2006. "A Bayesian approach to analysing the cost‐effectiveness of two primary care interventions aimed at improving attendance for breast screening," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 435-445, May.
    4. Martin Henriksson & Fredrik Lundgren & Per Carlsson, 2006. "Informing the efficient use of health care and health care research resources ‐ the case of screening for abdominal aortic aneurysm in Sweden," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1311-1322, December.
    5. Rachael L. Fleurence, 2007. "Setting priorities for research: a practical application of 'payback' and expected value of information," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1345-1357.
    6. 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.
    7. Andrea Manca & Nigel Rice & Mark J. Sculpher & Andrew H. Briggs, 2005. "Assessing generalisability by location in trial‐based cost‐effectiveness analysis: the use of multilevel models," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 471-485, May.
    8. Manca, A & Austin, P. C, 2008. "Using propensity score methods to analyse individual patient-level cost-effectiveness data from observational studies," Health, Econometrics and Data Group (HEDG) Working Papers 08/20, HEDG, c/o Department of Economics, University of York.
    9. 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.
    10. 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.
    11. Karl Claxton & Mark Sculpher & Chris McCabe & Andrew Briggs & Ron Akehurst & Martin Buxton & John Brazier & Tony O'Hagan, 2005. "Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 339-347, April.
    12. Rachael L. Fleurence, 2007. "Setting priorities for research: a practical application of ‘payback’ and expected value of information," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1345-1357, December.
    13. Meltzer, David, 2001. "Addressing uncertainty in medical cost-effectiveness analysis: Implications of expected utility maximization for methods to perform sensitivity analysis and the use of cost-effectiveness analysis to s," Journal of Health Economics, Elsevier, vol. 20(1), pages 109-129, January.
    14. N. J. Welton & A. E. Ades & D. M. Caldwell & T. J. Peters, 2008. "Research prioritization based on expected value of partial perfect information: a case‐study on interventions to increase uptake of breast cancer screening," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(4), pages 807-841, October.
    15. Bas Groot Koerkamp & Milton C. Weinstein & Theo Stijnen & M.H. Heijenbrok-Kal & M.G. Myriam Hunink, 2010. "Uncertainty and Patient Heterogeneity in Medical Decision Models," Medical Decision Making, , vol. 30(2), pages 194-205, March.
    16. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2005. "The value of implementation and the value of information: combined and uneven development," Working Papers 005cherp, Centre for Health Economics, University of York.
    17. M D Stevenson & J E Brazier & N W Calvert & M Lloyd-Jones & J E Oakley & J A Kanis, 2005. "Description of an individual patient methodology for calculating the cost-effectiveness of treatments for osteoporosis in women," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 214-221, February.
    18. Matthijs van den Berg & Filip Smit & Theo Vos & Pieter H M van Baal, 2011. "Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients," PLOS ONE, Public Library of Science, vol. 6(8), pages 1-7, August.
    19. Peter Bacchetti & Charles E. McCulloch & Mark R. Segal, 2008. "Simple, Defensible Sample Sizes Based on Cost Efficiency," Biometrics, The International Biometric Society, vol. 64(2), pages 577-585, June.
    20. A. E. Ades & Karl Claxton & Mark Sculpher, 2006. "Evidence synthesis, parameter correlation and probabilistic sensitivity analysis," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 373-381, April.

    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:sae:medema:v:28:y:2008:i:2:p:172-181. 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: SAGE Publications (email available below). General contact details of provider: .

    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.