Incremental Cost Effectiveness Ratios (ICERs) : The Silence of the Lambda  

Oleh:

Gafni, Amiram ; Birch, Stephen

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 9 (May 2006), page 2091-2100.
Topik: COST EFFECTIVENESS; economic evaluation. cost efefctiveness analysis; decision rules; incremental cost effectiveness ratio; health care costs

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.3 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Despite the central role of the threshold incremental cost effectiveness ratio (ICER) or labda (l), in the methods and application of cost effective analysis (CEA), little attention has been given to the determining the value of l. In this paper we consider what explains the silence of the l. The concept of the threshold ICER is critically appraised. We show that there is silence of the l with respect to justification of the value of ICER threshold, their use in decision making and their relationship to the opportunity cost of marginal resources. Moreover, the sound of silence extends to both automatic cut off and more sophisticated approached to the use of l in determining recommendations about health care programs. We argue that the threshold value provides no useful information for determining the efficiency of using available resources to support new health care programs. On the contrary, the threshold appoach has lead to decisions that resulted in increased expenditures on health care programs anc concerns about the sustainability of public funding for health care programs without any evidence of increases in total health gains. To improve efficiency in resource allocation, decision makers need information about the opportunity costs of programs.

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