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Is There Something Else Beyond Cost-Effectiveness Analysis for Public Health Decision Making?
Carlos Castañeda-Orjuela1, Mario García-Molina2, Fernando De la Hoz-Restrepo3
1Epidemiology and Public Health Evaluation Group, Public Health Department, Universidad Nacional de Colombia, Bogotá, Colombia; Colombian National Health Observatory, Instituto Nacional de Salud, Bogotá, Colombia.
Value in Health Regional Issues
|December 28, 2019
Summary
Cost-effectiveness analyses (CEA) are vital for healthcare decisions but require critical appraisal. Integrating economic evaluations with other rationalities is essential for sustainable health systems, especially in developing nations.
Area of Science:
- Health Economics
- Health Technology Assessment
- Public Health Policy
Background:
- Rising healthcare costs challenge the sustainability of health systems globally.
- Balancing payer needs with new technology manufacturer demands is a societal challenge.
- Efficacy and effectiveness data are crucial but insufficient for health intervention inclusion.
Purpose of the Study:
- To present a perspective on the use of cost-effectiveness analyses (CEA) for decision-making (DM).
- To highlight the need for considering multiple rationalities beyond economics in DM.
- To draw upon experiences from developing countries regarding CEA implementation.
Main Methods:
- Review of cost-effectiveness analysis (CEA) methodologies and their application in healthcare decision-making.
- Analysis of challenges in verifying and validating complex CEA results.
- Exploration of competing perspectives influencing CEA interpretation and DM.
Main Results:
- CEA use is widespread but methods are increasingly complex, challenging validation.
- CEA debates are intense in developed countries; reflections are weaker in developing countries due to capacity gaps.
- Critical analysis of CEA is necessary, particularly when investing public funds.
Conclusions:
- Cost-effectiveness analyses (CEA) are valuable but not the sole input for healthcare decision-making (DM).
- DM requires considering organizational, implementation, and feasibility aspects alongside economic evaluations.
- Integrating economic rationality with other considerations is crucial for effective and sustainable health policies, especially in resource-limited settings.
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