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Complementing the net benefit approach: A new framework for Bayesian cost-effectiveness analysis

Published online by Cambridge University Press:  22 October 2009

Miguel Angel Negrín Hernández ,
Francisco José Vázquez-Polo ,
Francisco Javier Girón González-Torre  and
Elías Moreno Bas
Miguel Angel Negrín Hernández
Affiliation:
University of Las Palmas de Gran Canaria
Francisco José Vázquez-Polo
Affiliation:
University of Las Palmas de Gran Canaria
Francisco Javier Girón González-Torre
Affiliation:
University of Málaga
Elías Moreno Bas
Affiliation:
University of Granada
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Abstract

Objectives: The aim of cost-effectiveness analysis is to maximize health benefits from a given budget, taking a societal perspective. Consequently, the comparison of alternative treatments or technologies is solely based on their expected effectiveness and cost. However, the expectation, or mean, poses important limitations as it might be a poor summary of the underlying distribution, for instance when the effectiveness is a categorical variable, or when the distributions of either effectiveness or cost present a high degree of asymmetry. Clinical variables often present these characteristics.

Methods: In this study, we present a framework for cost-effectiveness analysis based on the whole posterior distribution of effectiveness and cost.

Results: An application with real data is included to illustrate the analysis. Decision-making measures such as the incremental cost-effectiveness ratio, incremental net-benefit, and cost-effectiveness acceptability curves, can also be defined under the new framework.

Conclusions: This framework overcomes limitations of the mean and offers complementary information for the decision maker.

Keywords

Bayesian analysisCost-effectivenessNet benefitBinary effectivenessPredictive posterior densities
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 4 , October 2009 , pp. 537 - 545
Copyright
Copyright © Cambridge University Press 2009

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