The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services

Somnath (Som) Saha, Thomas J. Hoerger, Michael P. Pignone, Steven M. Teutsch, Mark Helfand, Jeanne S. Mandelblatt, David Atkins, Alfred O. Berg, Tracy A. Lieu, Cynthia D. Mulrow, Harold C. Sox, Carolyn Westhoff

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

As medical technology continues to expand and the cost of using all effective clinical services exceeds available resources, decisions about health care delivery may increasingly rely on assessing the cost-effectiveness of medical services. Cost-effectiveness is particularly relevant for decisions about how to implement preventive services, because these decisions typically represent major investments in the future health of large populations. As such, decisions regarding the implementation of preventive services frequently involve, implicitly if not explicitly, consideration of costs. Cost-effectiveness analysis summarizes the expected benefits, harms, and costs of alternative strategies to improve health and has become an important tool for explicitly incorporating economic considerations into clinical decision making. Acknowledging the usefulness of this tool, the third U.S. Preventive Services Task Force (USPSTF) has initiated a process for systematically reviewing cost-effectiveness analyses as an aid in making recommendations about clinical preventive services. In this paper, we provide an overview and examples of roles for using cost-effectiveness analyses to inform preventive services recommendations, discuss limitations of cost-effectiveness data in shaping evidence-based preventive health care policies, outline the USPSTF approach to using cost-effectiveness analyses, and discuss the methods the USPSTF is developing to assess the quality and results of cost-effectiveness studies. While this paper focuses on clinical preventive services (i.e., screening, counseling, immunizations, and chemoprevention), the framework we have developed should be broadly portable to other health care services.

Original languageEnglish (US)
Pages (from-to)36-43
Number of pages8
JournalAmerican Journal of Preventive Medicine
Volume20
Issue number3 SUPPL.
StatePublished - 2001

Fingerprint

Art
Cost-Benefit Analysis
Advisory Committees
Preventive Health Services
Delivery of Health Care
Costs and Cost Analysis
Evidence-Based Practice
Chemoprevention
Health
Health Policy
Health Services
Counseling
Immunization
Economics
Technology

Keywords

  • Cost-benefit analysis
  • Costs and cost analysis
  • Economic models
  • Evidence-based medicine
  • MEDLINE
  • Methods
  • Prac-tice guidelines
  • Preventive health services

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health

Cite this

The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services. / Saha, Somnath (Som); Hoerger, Thomas J.; Pignone, Michael P.; Teutsch, Steven M.; Helfand, Mark; Mandelblatt, Jeanne S.; Atkins, David; Berg, Alfred O.; Lieu, Tracy A.; Mulrow, Cynthia D.; Sox, Harold C.; Westhoff, Carolyn.

In: American Journal of Preventive Medicine, Vol. 20, No. 3 SUPPL., 2001, p. 36-43.

Research output: Contribution to journalArticle

Saha, SS, Hoerger, TJ, Pignone, MP, Teutsch, SM, Helfand, M, Mandelblatt, JS, Atkins, D, Berg, AO, Lieu, TA, Mulrow, CD, Sox, HC & Westhoff, C 2001, 'The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services', American Journal of Preventive Medicine, vol. 20, no. 3 SUPPL., pp. 36-43.
Saha, Somnath (Som) ; Hoerger, Thomas J. ; Pignone, Michael P. ; Teutsch, Steven M. ; Helfand, Mark ; Mandelblatt, Jeanne S. ; Atkins, David ; Berg, Alfred O. ; Lieu, Tracy A. ; Mulrow, Cynthia D. ; Sox, Harold C. ; Westhoff, Carolyn. / The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services. In: American Journal of Preventive Medicine. 2001 ; Vol. 20, No. 3 SUPPL. pp. 36-43.
@article{4cc273dc498c439992d6066ec022d4b2,
title = "The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services",
abstract = "As medical technology continues to expand and the cost of using all effective clinical services exceeds available resources, decisions about health care delivery may increasingly rely on assessing the cost-effectiveness of medical services. Cost-effectiveness is particularly relevant for decisions about how to implement preventive services, because these decisions typically represent major investments in the future health of large populations. As such, decisions regarding the implementation of preventive services frequently involve, implicitly if not explicitly, consideration of costs. Cost-effectiveness analysis summarizes the expected benefits, harms, and costs of alternative strategies to improve health and has become an important tool for explicitly incorporating economic considerations into clinical decision making. Acknowledging the usefulness of this tool, the third U.S. Preventive Services Task Force (USPSTF) has initiated a process for systematically reviewing cost-effectiveness analyses as an aid in making recommendations about clinical preventive services. In this paper, we provide an overview and examples of roles for using cost-effectiveness analyses to inform preventive services recommendations, discuss limitations of cost-effectiveness data in shaping evidence-based preventive health care policies, outline the USPSTF approach to using cost-effectiveness analyses, and discuss the methods the USPSTF is developing to assess the quality and results of cost-effectiveness studies. While this paper focuses on clinical preventive services (i.e., screening, counseling, immunizations, and chemoprevention), the framework we have developed should be broadly portable to other health care services.",
keywords = "Cost-benefit analysis, Costs and cost analysis, Economic models, Evidence-based medicine, MEDLINE, Methods, Prac-tice guidelines, Preventive health services",
author = "Saha, {Somnath (Som)} and Hoerger, {Thomas J.} and Pignone, {Michael P.} and Teutsch, {Steven M.} and Mark Helfand and Mandelblatt, {Jeanne S.} and David Atkins and Berg, {Alfred O.} and Lieu, {Tracy A.} and Mulrow, {Cynthia D.} and Sox, {Harold C.} and Carolyn Westhoff",
year = "2001",
language = "English (US)",
volume = "20",
pages = "36--43",
journal = "American Journal of Preventive Medicine",
issn = "0749-3797",
publisher = "Elsevier Inc.",
number = "3 SUPPL.",

}

TY - JOUR

T1 - The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services

AU - Saha, Somnath (Som)

AU - Hoerger, Thomas J.

AU - Pignone, Michael P.

AU - Teutsch, Steven M.

AU - Helfand, Mark

AU - Mandelblatt, Jeanne S.

AU - Atkins, David

AU - Berg, Alfred O.

AU - Lieu, Tracy A.

AU - Mulrow, Cynthia D.

AU - Sox, Harold C.

AU - Westhoff, Carolyn

PY - 2001

Y1 - 2001

N2 - As medical technology continues to expand and the cost of using all effective clinical services exceeds available resources, decisions about health care delivery may increasingly rely on assessing the cost-effectiveness of medical services. Cost-effectiveness is particularly relevant for decisions about how to implement preventive services, because these decisions typically represent major investments in the future health of large populations. As such, decisions regarding the implementation of preventive services frequently involve, implicitly if not explicitly, consideration of costs. Cost-effectiveness analysis summarizes the expected benefits, harms, and costs of alternative strategies to improve health and has become an important tool for explicitly incorporating economic considerations into clinical decision making. Acknowledging the usefulness of this tool, the third U.S. Preventive Services Task Force (USPSTF) has initiated a process for systematically reviewing cost-effectiveness analyses as an aid in making recommendations about clinical preventive services. In this paper, we provide an overview and examples of roles for using cost-effectiveness analyses to inform preventive services recommendations, discuss limitations of cost-effectiveness data in shaping evidence-based preventive health care policies, outline the USPSTF approach to using cost-effectiveness analyses, and discuss the methods the USPSTF is developing to assess the quality and results of cost-effectiveness studies. While this paper focuses on clinical preventive services (i.e., screening, counseling, immunizations, and chemoprevention), the framework we have developed should be broadly portable to other health care services.

AB - As medical technology continues to expand and the cost of using all effective clinical services exceeds available resources, decisions about health care delivery may increasingly rely on assessing the cost-effectiveness of medical services. Cost-effectiveness is particularly relevant for decisions about how to implement preventive services, because these decisions typically represent major investments in the future health of large populations. As such, decisions regarding the implementation of preventive services frequently involve, implicitly if not explicitly, consideration of costs. Cost-effectiveness analysis summarizes the expected benefits, harms, and costs of alternative strategies to improve health and has become an important tool for explicitly incorporating economic considerations into clinical decision making. Acknowledging the usefulness of this tool, the third U.S. Preventive Services Task Force (USPSTF) has initiated a process for systematically reviewing cost-effectiveness analyses as an aid in making recommendations about clinical preventive services. In this paper, we provide an overview and examples of roles for using cost-effectiveness analyses to inform preventive services recommendations, discuss limitations of cost-effectiveness data in shaping evidence-based preventive health care policies, outline the USPSTF approach to using cost-effectiveness analyses, and discuss the methods the USPSTF is developing to assess the quality and results of cost-effectiveness studies. While this paper focuses on clinical preventive services (i.e., screening, counseling, immunizations, and chemoprevention), the framework we have developed should be broadly portable to other health care services.

KW - Cost-benefit analysis

KW - Costs and cost analysis

KW - Economic models

KW - Evidence-based medicine

KW - MEDLINE

KW - Methods

KW - Prac-tice guidelines

KW - Preventive health services

UR - http://www.scopus.com/inward/record.url?scp=0035316628&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035316628&partnerID=8YFLogxK

M3 - Article

C2 - 11306230

AN - SCOPUS:0035316628

VL - 20

SP - 36

EP - 43

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

IS - 3 SUPPL.

ER -