Karlsson G, Johannesson M
Centre for Health Economics, Stockholm School of Economics, Sweden.
Pharmacoeconomics. 1996 Feb;9(2):113-20. doi: 10.2165/00019053-199609020-00003.
It has become increasingly popular to carry out cost-effectiveness analyses in economic evaluations of healthcare programmes. Cost-effectiveness analysis is based on the maximisation of the health effects for a given amount of resources. However, many published studies fail to report the results of cost-effectiveness analysis in a way that is consistent with this underlying aim. The aim of this article is to demonstrate the decision rules of cost-effectiveness analysis in an easily accessible way for practitioners in the field. A hypothetical example is used to demonstrate the decision rules of cost-effectiveness analysis, and we also show how to estimate the appropriate incremental cost-effectiveness ratios and how to exclude dominated alternatives. It is then shown how fixed budgets or predetermined prices per effectiveness unit can be used as decision rules to maximise health effects and to determine which programmes to implement on the basis of incremental cost-effectiveness ratios. We hope that the article will contribute towards an increased understanding and application of the appropriate decision rules of cost-effectiveness analysis, so that the results of cost-effectiveness analyses can be interpreted meaningfully by decision makers.
在医疗保健项目的经济评估中进行成本效益分析已变得越来越普遍。成本效益分析基于在给定资源量的情况下使健康效果最大化。然而，许多已发表的研究未能以与这一根本目标相一致的方式报告成本效益分析的结果。本文的目的是以一种便于该领域从业者理解的方式展示成本效益分析的决策规则。通过一个假设的例子来演示成本效益分析的决策规则，我们还将展示如何估计适当的增量成本效益比以及如何排除占优的替代方案。然后说明如何将固定预算或每个效益单位的预定价格用作决策规则，以实现健康效果最大化，并根据增量成本效益比确定实施哪些项目。我们希望本文将有助于增进对成本效益分析适当决策规则的理解和应用，以便决策者能够有意义地解读成本效益分析的结果。
