Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-16T17:08:56.582Z Has data issue: false hasContentIssue false

Potential Inconsistencies Between Cost-Effectiveness and Cost-Utility Analyses: An Upstairs/Downstairs Socioeconomic Distinction

Published online by Cambridge University Press:  10 March 2009

Brian E. Rittenhouse
Affiliation:
University of North Carolina at Chapel Hill

Abstarct

This paper indicates that certain economic evaluation methods (cost-effectiveness and cost-utility analyses) may yield inconsistent results. Along with the lack of formal grounding of these methods in economic “first principles,” this finding suggests the possible benefit of greater reliance on the more formally developed method of cost-benefit analysis.

Type
Research Note
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Anderson, L. G., & Settle, R. F.Benefit-cost analysis: A practical guide. Lexington, MA: D. C. Heath and Company, 1977.Google Scholar
2.Arrow, K. J. Behavior under uncertainty and its implications for policy. In Stigum, B. P. & Wenstop, F. (eds.), Foundations of utility and risk theory with applications. Boston, MA: D. Reidel Publishing Co., 1983, 1932.CrossRefGoogle Scholar
3.Baumol, W. J. On the discount rate for public projects. In Haveman, R. H. & Margolis, J., Public expenditure and policy analysis, 2nd ed.Chicago, IL: Rand McNally College Publishing Co., 1977, 161–79.Google Scholar
4.Buckingham, K.Risks in utility assessment and risks of medical interventions (Letter to the editor). Medical Decision Making, 1993, 13, 167.CrossRefGoogle Scholar
5.Dasgupta, A. K., & Pearce, D. W.Cost-benefit analysis: Theory and practice. London: MacMillan, 1972.Google Scholar
6.Drummond, M. F. (ed), Economic appraisal of health technology in the European community. New York: Oxford University Press, 1987, 23.Google Scholar
7.Drummond, M. F., Stoddart, G. L., & Torrance, G. W.Methods for the economic evaluation of health care programmes. New York: Oxford University Press, 1987.Google Scholar
8.Drummond, M. F., Torrance, G. W., & Mason, J.Cost-effectiveness league tables: More harm than good? Social Science and Medicine, 1993, 37, 3340.Google Scholar
9.Dupuit, J. De la mesure de l'utilite des Travaux Publics. Annales des ponts et chaussees, 2ieme Serie, 8.Google Scholar
10.Finkler, S. A.The distinction between cost and charges. Annals of Internal Medicine, 1982, 96, 102–09.Google Scholar
11.Gafni, A., & Mehrez, A.Risks in utility assessment and risks of medical interventions (reply to letter to the editor). Medical Decision Making, 1993, 13, 168.Google Scholar
12.Garber, A. M., & Phelps, C. E. “Economic foundations of cost-effectiveness analysis.” NBER working paper.Google Scholar
13.Hornberger, J. C., Redelmeier, D. A., & Petersen, J.Variability among methods to assess patients' well-being and consequent effect on a cost-effectiveness analysis. Journal of Clinical Epidemiology, 1992, 45, 505–12.Google Scholar
14.Luce, B. R., & Elixhauser, A.Standards for socioeconomic evaluation of health care products and services. New York: Springer-Verlag, 1990.CrossRefGoogle Scholar
15.McGuire, A., Henderson, J., & Mooney, G.The economics of healthcare: An introductory text. New York: Routledge & Kegan Paul Inc., 1988.Google Scholar
16.McNeil, B. J., Pauker, S. G., Sox, H. C. Jr., & Tversky, A.On the elicitation of preferences for alternative therapies. New England Journal of Medicine, 1982, 306, 1259–62.CrossRefGoogle ScholarPubMed
17.Mehrez, A., & Gafni, A.Preference based outcome measures for economic evaluation of drug interventions: Quality adjusted life years (QALYs) versus healthy years equivalents (HYEs). PharmacoEconomics, 1992, 1, 338–45.CrossRefGoogle ScholarPubMed
18.Mishan, E. J.Cost-benefit analysis. New York: Praeger Publishers, 1976.Google Scholar
19.Pearce, D. W.Cost-benefit analysis, 2nd ed.London: Macmillan, 1983.CrossRefGoogle Scholar
20.Phelps, C. E., & Mushlin, A. I.On the (near) equivalence of cost-effectiveness and cost benefit analyses. International Journal of Technology Assessment in Health Care, 1991, 7, 1221.Google Scholar
21.Read, J. L., Quinn, R. J., Berwick, D. M. et al. Preferences for health outcomes: Comparisons of assessment methods. Medical Decision Making, 1984, 4, 315.CrossRefGoogle ScholarPubMed
22.Stokey, E., & Zeckhauser, R.A primer for policy analysis. New York: W. W. Horton & Company, Inc., 1978.Google Scholar
23.Sugden, R., & Williams, A.The principles of practical cost-benefit analysis. New York:Oxford University Press, 1978.Google Scholar
24.von Neuman, J., & Morganstern, O.Theory of games and economic behavior. New York: Wiley, 1953.Google Scholar
25.Weinstein, M. C., Fineberg, H. V., Elstein, A. S., et al. Clinical decision analysis. Philadelphia, PA: W. B. Saunders Company, 1980.Google Scholar