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Related Experiment Videos

Incremental and average cost-effectiveness ratios: will physicians make a distinction?

John C Hershey1, David A Asch, Christopher Jepson

  • 1Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia. PA 19104, USA. hershey@wharton.upenn.edu

Risk Analysis : an Official Publication of the Society for Risk Analysis
|March 15, 2003
PubMed
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How cost-effectiveness information is presented significantly impacts physician decision-making for healthcare interventions. Incremental cost-effectiveness ratios, unlike average ratios, reduce preference for expensive options in unfamiliar settings.

Area of Science:

  • Health economics
  • Medical decision making
  • Health services research

Background:

  • Physicians face increasing pressure to utilize cost-effectiveness data for healthcare interventions.
  • The presentation format of cost-effectiveness information may influence clinical choices.
  • Understanding this influence is crucial for optimizing resource allocation in healthcare.

Purpose of the Study:

  • To investigate how different types of cost-effectiveness ratios (average vs. incremental) affect physicians' choices in hypothetical screening scenarios.
  • To examine whether the familiarity of the clinical setting influences the impact of ratio presentation on decision-making.

Main Methods:

  • Physicians were presented with hypothetical cancer screening scenarios.
  • Scenarios varied in the type of cost-effectiveness ratios provided (average vs. incremental).

Related Experiment Videos

  • Scenarios also differed in clinical setting familiarity (familiar vs. unfamiliar).

    • Main Results:

    • Incremental cost-effectiveness ratios significantly decreased physician preference for costly screening strategies in two out of three unfamiliar settings.
    • No significant difference in preference was observed in familiar settings, suggesting established practice patterns may override presentation effects.
    • Average cost-effectiveness ratios, commonly reported, may obscure the true cost of incremental health gains.

    Conclusions:

    • The way cost-effectiveness information is presented critically influences physician choices, particularly in unfamiliar clinical contexts.
    • Average cost-effectiveness ratios can potentially mislead physicians towards less cost-effective interventions by masking incremental costs.
    • Clearer reporting of incremental cost-effectiveness is essential for informed medical decision-making and efficient healthcare resource allocation.