Calculating and Interpreting ICERs and Net Benefit.

Area of Science:

• Health Economics
• Health Technology Assessment
• Decision Science

Background:

• The incremental cost-effectiveness ratio (ICER) is a standard metric in health technology assessment (HTA) for economic evaluations.
• However, ICERs have limitations in summarizing and interpreting cost-effectiveness data.
• Alternative measures based on net benefit offer a more robust approach.

Purpose of the Study:

• To introduce methods for calculating and interpreting net benefit measures as alternatives to ICERs.
• To illustrate how net benefit measures can be used for various HTA tasks, including strategy identification and ranking.
• To present a novel visual approach using the cost-effectiveness plane for interpreting net benefit.

Main Methods:

• Description of calculation methods for both ICERs and net benefit measures.
• Application of these measures to identify the most cost-effective strategy, rank strategies, and determine cost-effectiveness magnitude.
• Introduction of a new visualization technique on the cost-effectiveness plane.

Main Results:

• Net benefit measures provide a more comprehensive framework for cost-effectiveness analysis compared to ICERs.
• The proposed methods allow for ordinal and cardinal interpretations of cost-effectiveness.
• The cost-effectiveness plane offers enhanced visual interpretation of net benefit measures, overcoming limitations of the efficiency frontier.

Conclusions:

• Reporting and considering ICERs is unnecessary; net benefit measures are preferred for economic evaluations in HTA.
• Understanding and applying net benefit measures, including novel visualization techniques, is crucial for robust health technology assessment.
• These methods enhance the ability of HTA agencies to make informed decisions regarding health interventions.