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Related Experiment Videos

Why don't Americans use cost-effectiveness analysis?

Peter J Neumann1

  • 1Program on the Economic Evaluation of Medical Technology, Center for Risk Analysis, Harvard School of Public Health, Boston, MA 02115, USA. pneumann@hsph.harvard.edu

The American Journal of Managed Care
|May 22, 2004
PubMed
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When Do Published Cost-Effectiveness Analyses Include Societal Costs? An Empirical Analysis, 2013-2023.

Medical decision making : an international journal of the Society for Medical Decision Making·2025

Cost-effectiveness analysis (CEA) provides a rational framework for resource allocation in healthcare. Despite its benefits, US policymakers show reluctance in formally adopting CEA, hindering evidence-based healthcare advancements.

Area of Science:

  • Health Economics
  • Health Services Research
  • Decision Analysis

Background:

  • Cost-effectiveness analysis (CEA) is promoted as a structured approach to optimize resource allocation in healthcare.
  • Despite decades of promotion, formal adoption by US policymakers remains limited.
  • This resistance contrasts with the broader trend towards evidence-based medicine in the US healthcare sector.

Purpose of the Study:

  • To examine the reasons behind the reluctance to formally adopt CEA in the United States.
  • To explore potential strategies for advancing the use and acceptance of CEA in US healthcare policy.

Main Methods:

  • Qualitative examination of policy adoption barriers.
  • Literature review on economic evaluation in healthcare.

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  • Analysis of historical trends in US healthcare policy.

    • Main Results:

    • Identified significant resistance to incorporating economic evidence into US healthcare decision-making.
    • Highlighted a gap between the theoretical benefits of CEA and its practical implementation in policy.
    • Noted the unique challenge posed by this resistance in the context of evidence-based medicine.

    Conclusions:

    • The formal integration of CEA into US healthcare policy faces substantial barriers.
    • Addressing these barriers is crucial for advancing evidence-based healthcare and improving resource stewardship.
    • Further research and targeted strategies are needed to overcome resistance and promote CEA adoption.