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Addressing risk preferences in cost-effectiveness analyses
Joshua Graff Zivin1, John F Bridges
1Department of Health Policy and Management, Mailman School of Public Health, International Center for Health Outcomes and Innovation Research, Columbia University, New York, NY, USA.
Abstract:
Cost-effectiveness analysis is a form of economic evaluation that compares that compares the costs and effectiveness of health interventions, where effectiveness is measured in a single scale. Despite the growth in the popularity of cost-effectiveness analysis, very few cost-effectiveness analyses adequately measure and account for uncertainty. In the health economics literature, two schools of thought are emerging. The first takes a statistical approach to uncertainty by focusing on the likelihood that a decision making error will be made. The second approach applies and develops economic theories of risk preference that consider the welfare implications for a patient when they are presented with interventions that have uncertain health outcomes. Cost-effectiveness analyses need to account for risk preferences if they claim to be increasing patient welfare.
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