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Patient experience - the ingredient missing from cost-effectiveness calculations.

David Curtis1

  • 1Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, London, UK.

Patient Preference and Adherence
|July 28, 2011
PubMed
Summary

Patient financial costs and subjective experiences are often ignored in healthcare cost-effectiveness analyses. This study reveals the public assigns significant financial value to routine medical interventions, highlighting the need for their inclusion in benefit evaluations.

Keywords:
financial costmedical interventionspreventionscreening

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Area of Science:

  • Health Economics
  • Patient-Reported Outcomes
  • Public Health Policy

Background:

  • Standard cost-effectiveness analyses (CEAs) by bodies like the UK National Institute of Clinical Excellence (NICE) primarily compare intervention benefits against direct financial costs to the health service.
  • Current CEAs often overlook the patient's subjective experience, including non-financial costs such as pain, distress, and indignity, as well as out-of-pocket expenses.

Purpose of the Study:

  • To investigate the financial value the public assigns to routine medical interventions.
  • To highlight the discrepancy between standard CEA and patient-perceived costs.
  • To argue for the inclusion of patient-borne costs in healthcare intervention evaluations.

Main Methods:

  • An Internet survey was conducted to gather public perceptions.
  • Participants were asked to assign financial values to common medical interventions.

Main Results:

  • The public assigns a substantial financial cost to routine medical interventions, such as regular medication adherence or attending clinic appointments for vaccinations.
  • These perceived patient costs are significant and warrant consideration in healthcare decision-making.

Conclusions:

  • Current cost-effectiveness calculations are incomplete as they routinely ignore the subjective financial costs experienced by patients.
  • Incorporating patient-borne costs into evaluations is crucial for a comprehensive understanding of medical intervention benefits and for equitable healthcare policy.
  • Future health economic models should integrate patient financial burden to provide a more holistic assessment of intervention value.