The death of cost-minimization analysis?

Area of Science:

• Health Economics
• Decision Science
• Pharmacoeconomics

Background:

• Four evaluation methods are common: cost-benefit analysis (CBA), cost-utility analysis (CUA), cost-effectiveness analysis (CEA), and cost-minimization analysis (CMA).
• The appropriateness of CMA is often overestimated in economic evaluations.

Purpose of the Study:

• To critically assess the limited circumstances where cost-minimization analysis (CMA) is appropriate.
• To advocate for advanced analytical methods over inappropriate use of CMA.

Main Methods:

• Critique of separate and sequential hypothesis testing for cost and effect differences.
• Emphasis on joint density estimation of cost and effect differences.
• Utilization of cost-effectiveness acceptability curves (CEACs) for uncertainty quantification.

Main Results:

• CMA is seldom appropriate, often due to misapplication of statistical tests.
• Separate hypothesis tests on costs and effects are insufficient for determining the need for incremental analyses.
• Focusing on the joint distribution of costs and effects provides a more accurate assessment.

Conclusions:

• The use of cost-minimization analysis (CMA) should be significantly restricted.
• Advanced methods like CEACs are essential for accurately representing uncertainty in economic evaluations.
• Analysts should prioritize robust methods over simplistic approaches like CMA.