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Stochastic league tables: communicating cost‐effectiveness results to decision‐makers

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  • Raymond C.W. Hutubessy
  • Rob M.P.M. Baltussen
  • David B. Evans
  • Jan J. Barendregt
  • Christopher J.L. Murray

Abstract

The presentation of the results of uncertainty analysis in cost‐effectiveness analysis (CEA) in the literature has been relatively academic with little attention paid to the question of how decision‐makers should interpret the information particularly when confidence intervals overlap. This question is especially relevant to sectoral CEA providing information on the costs and effects of a wide range of interventions. This paper introduces stochastic league tables to inform decision‐makers about the probability that a specific intervention would be included in the optimal mix of interventions for various levels of resource availability, taking into account the uncertainty surrounding costs and effectiveness. This information helps decision‐makers decide on the relative attractiveness of different intervention mixes, and also on the implications for trading gains in efficiency for gains in other goals such as reducing health inequalities and increasing health system responsiveness. Copyright © 2001 John Wiley & Sons, Ltd.

Suggested Citation

  • Raymond C.W. Hutubessy & Rob M.P.M. Baltussen & David B. Evans & Jan J. Barendregt & Christopher J.L. Murray, 2001. "Stochastic league tables: communicating cost‐effectiveness results to decision‐makers," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 473-477, July.
    • Handle: RePEc:wly:hlthec:v:10:y:2001:i:5:p:473-477
    DOI: 10.1002/hec.614
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    References listed on IDEAS

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    1. Joanne Lord & Maxwell A. Asante, 1999. "Estimating uncertainty ranges for costs by the bootstrap procedure combined with probabilistic sensitivity analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(4), pages 323-333, June.
    2. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
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    4. Andrew H. Briggs & David E. Wonderling & Christopher Z. Mooney, 1997. "Pulling cost‐effectiveness analysis up by its bootstraps: A non‐parametric approach to confidence interval estimation," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 327-340, July.
    5. 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.
    6. Birch, Stephen & Gafni, Amiram, 1994. "Cost-effectiveness ratios: in a league of their own," Health Policy, Elsevier, vol. 28(2), pages 133-141, May.
    7. Andrew Briggs & Paul Fenn, 1998. "Confidence intervals or surfaces? Uncertainty on the cost‐effectiveness plane," Health Economics, John Wiley & Sons, Ltd., vol. 7(8), pages 723-740, December.
    8. Drummond, Michael & Torrance, George & Mason, James, 1993. "Cost-effectiveness league tables: More harm than good?," Social Science & Medicine, Elsevier, vol. 37(1), pages 33-40, July.
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    Cited by:

    1. Pieter H. M. van Baal & Talitha L. Feenstra & Rudolf T. Hoogenveen & G. Ardine de Wit & Werner B. F. Brouwer, 2007. "Unrelated medical care in life years gained and the cost utility of primary prevention: in search of a ‘perfect’ cost–utility ratio," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 421-433, April.
    2. Raymond C. W. Hutubessy & Louis W. Niessen & Rob F. Dijkstra & Ton F. Casparie & Frans F. Rutten, 2005. "Stochastic league tables: an application to diabetes interventions in the Netherlands," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 445-455, May.
    3. Maiwenn J. Al & Talitha L. Feenstra & Ben A. van Hout, 2005. "Optimal allocation of resources over health care programmes: dealing with decreasing marginal utility and uncertainty," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 655-667, July.
    4. Michaël Schwarzinger & Jean‐Louis Lanoë & Erik Nord & Isabelle Durand‐Zaleski, 2004. "Lack of multiplicative transitivity in person trade‐off responses," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 171-181, February.
    5. David Bishai & Divya Nair & Taghreed Adam, 2012. "Economics of Public Health Interventions for Children in Developing Countries," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 5, Edward Elgar Publishing.
    6. David B. Evans & Dan Chisholm & Tessa Tan-Torres Edejer, 2012. "Generalized Cost-effectiveness Analysis: Principles and Practice," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 48, Edward Elgar Publishing.
    7. Douglas Coyle, 2003. "Determining the optimal combinations of mutually exclusive interventions: a response to Hutubessy and colleagues," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 159-162, February.

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