Evaluation of cost-effectiveness research: a survey of recent publications

Because of interest in cost containment, a series of basic guidelines for performing cost-effectiveness research has evolved in the past decade. These guidelines advise that the perspective of the cost study be clarified, that all applicable costs, benefits, and health outcomes be included, and that discounting and sensitivity analyses be performed where appropriate. A survey of 47 recent cost-effectiveness publications selected via MEDLINE and manual searches confirms our hypothesis that many studies do not adhere to these guidelines. Since such short-comings can lead to misleading or ill-founded conclusions, attention must be paid to the principles of cost-effectiveness research to avoid making major, inappropriate health policy decisions.