Cost-effectiveness acceptability curves--caveats quantified.

Abstract:

:Cost-effectiveness acceptability curves (CEACs) have become widely used in applied health technology assessment and at the same time are criticized as unreliable decision-making tool. In this paper we show how using CEACs differs from maximizing expected net benefit (NB) and when it can lead to inconsistent decisions. In the case of comparing two alternatives we show the limits of the discrepancy between CEAC and expected NB approach and link it with expected value of perfect information. We also show how the shape of CEAC is influenced by the skewness of estimate of expected NB distribution, the correlation between cost and effect estimates and their variance. In the case of more than two options we show when using CEACs can lead to non-transitive choices in pair-wise comparisons and when it lacks independence of irrelevant alternatives property in joint comparisons.

journal_name

Health Econ

journal_title

Health economics

authors

Jakubczyk M,Kamiński B

doi

10.1002/hec.1534

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

955-63

issue

8

eissn

1057-9230

issn

1099-1050

journal_volume

19

pub_type

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