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Optimal allocation of resources over health care programmes: dealing with decreasing marginal utility and uncertainty

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  • Maiwenn J. Al
  • Talitha L. Feenstra
  • Ben A. van Hout

Abstract

This paper addresses the problem of how to value health care programmes with different ratios of costs to effects, specifically when taking into account that these costs and effects are uncertain. First, the traditional framework of maximising health effects with a given health care budget is extended to a flexible budget using a value function over money and health effects. Second, uncertainty surrounding costs and effects is included in the model using expected utility. Other approaches to uncertainty that do not specify a utility function are discussed and it is argued that these also include implicit notions about risk attitude. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • 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.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:7:p:655-667
    DOI: 10.1002/hec.973
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    References listed on IDEAS

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    1. Weinstein, Milton & Zeckhauser, Richard, 1973. "Critical ratios and efficient allocation," Journal of Public Economics, Elsevier, vol. 2(2), pages 147-157, April.
    2. Birch, Stephen & Donaldson, Cam, 1987. "Applications of cost-benefit analysis to health care : Departures from welfare economic theory," Journal of Health Economics, Elsevier, vol. 6(3), pages 211-225, September.
    3. Sugden, Robert & Williams, Alan, 1978. "The Principles of Practical Cost-Benefit Analysis," OUP Catalogue, Oxford University Press, number 9780198770411.
    4. Stinnett, Aaron A. & Paltiel, A. David, 1996. "Mathematical programming for the efficient allocation of health care resources," Journal of Health Economics, Elsevier, vol. 15(5), pages 641-653, October.
    5. Joshua Graff Zivin, 2001. "Cost‐effectiveness analysis with risk aversion," Health Economics, John Wiley & Sons, Ltd., vol. 10(6), pages 499-508, September.
    6. Keeney,Ralph L. & Raiffa,Howard, 1993. "Decisions with Multiple Objectives," Cambridge Books, Cambridge University Press, number 9780521438834.
    7. Ben-Zion, Uri & Gafni, Amiram, 1983. "Evaluation of public investment in health care : Is the risk irrelevant?," Journal of Health Economics, Elsevier, vol. 2(2), pages 161-165, August.
    8. Kenneth J. Arrow & Robert C. Lind, 1974. "Uncertainty and the Evaluation of Public Investment Decisions," Palgrave Macmillan Books, in: Chennat Gopalakrishnan (ed.), Classic Papers in Natural Resource Economics, chapter 3, pages 54-75, Palgrave Macmillan.
    9. Eugene M. Laska & Morris Meisner & Carole Siegel, 1997. "Statistical Inference for Cost–Effectiveness Ratios," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 229-242, May.
    10. 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.
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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. McKenna, Claire & Chalabi, Zaid & Epstein, David & Claxton, Karl, 2010. "Budgetary policies and available actions: A generalisation of decision rules for allocation and research decisions," Journal of Health Economics, Elsevier, vol. 29(1), pages 170-181, January.
    3. Sanjay Mehrotra & Kibaek Kim, 2011. "Outcome based state budget allocation for diabetes prevention programs using multi-criteria optimization with robust weights," Health Care Management Science, Springer, vol. 14(4), pages 324-337, November.
    4. Gandjour, Afschin & Chernyak, Nadja, 2011. "A new prize system for drug innovation," Health Policy, Elsevier, vol. 102(2), pages 170-177.
    5. H. Koffijberg & G. A. de Wit & T. L. Feenstra, 2012. "Communicating Uncertainty in Economic Evaluations," Medical Decision Making, , vol. 32(3), pages 477-487, May.
    6. Angelis, Aris & Kanavos, Panos, 2017. "Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework," Social Science & Medicine, Elsevier, vol. 188(C), pages 137-156.
    7. Sergey S. Rabotyagov, 2010. "Ecosystem Services under Benefit and Cost Uncertainty: An Application to Soil Carbon Sequestration," Land Economics, University of Wisconsin Press, vol. 86(4), pages 668-686.
    8. Pedram Sendi, 2021. "Dealing with Bad Risk in Cost-Effectiveness Analysis: The Cost-Effectiveness Risk-Aversion Curve," PharmacoEconomics, Springer, vol. 39(2), pages 161-169, February.
    9. Kirwin, Erin & Meacock, Rachel & Round, Jeff & Sutton, Matt, 2022. "The diagonal approach: A theoretic framework for the economic evaluation of vertical and horizontal interventions in healthcare," Social Science & Medicine, Elsevier, vol. 301(C).
    10. Douwe Postmus & Tommi Tervonen & Gert Valkenhoef & Hans Hillege & Erik Buskens, 2014. "A multi-criteria decision analysis perspective on the health economic evaluation of medical interventions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(7), pages 709-716, September.
    11. 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.
    12. Afschin Gandjour, 2015. "Comment on: “Healthy Decisions: Towards Uncertainty Tolerance in Healthcare Policy”," PharmacoEconomics, Springer, vol. 33(9), pages 981-982, September.

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