Return-on-Investment in Health Economic Evaluation: An Exploratory Analysis.

Area of Science:

• Health economics
• Economic evaluation methods

Background:

• Return-on-investment (ROI) measures lack standardized guidelines for calculation and threshold development.
• Existing economic evaluation methods like cost-effectiveness analysis have established guidelines, unlike ROI.

Purpose of the Study:

• To explore methodological rigor and threshold development for ROI measures in health economic evaluations.
• To propose initial ROI threshold measures using economic concepts.

Main Methods:

• Utilized economic concepts including opportunity cost, Pareto optimality, and fairness.
• Proposed initial threshold values for ROI calculations based on opportunity cost.

Main Results:

• Proposed an initial ROI threshold of 0.08 for monetizing health benefits and -0.47 for non-monetized benefits.
• Highlighted concerns about ROI methodology potentially leading to suboptimal resource allocation and ethical issues due to bias.

Conclusions:

• Methodological shortcomings in ROI measures contribute to significant variation compared to other economic evaluation measures.
• Establishing thresholds and guidelines for ROI calculation is crucial to narrow variation, ensure Pareto optimality and fairness, and increase utility.