Cost-effectiveness analyses in a changing health care environment: new issues and challenges

Rising health care expenditures have fuelled the demand for more information about the impact of new medical products on costs and outcomes. Cost-effectiveness analysis (CEA) is one technique used to inform health care decisionmakers. Recent analyses show an increase in the number of CEAs published annually, although study quality remains unchanged. While advances in CEA methodology have been significant, further progress will require changes in the way we conduct basic clinical research, and a greater commitment by groups not usually involved in these analyses.