TY - JOUR
T1 - The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services
AU - Saha, Somnath
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
N1 - Funding Information:
Supported by contract #290-97-0018 (Task Order #2) to the Oregon Health Sciences University (SS, MH) and contract #290-97-0011 (Task Order #3) to the Research Triangle Institute/University of North Carolina (TJH, MP) from the Agency for Healthcare Research and Quality, and contract # DAMD17-94-J-4212 from the Department of the Army (JSM). The views expressed in this article are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality or the Department of the Army.
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
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U2 - 10.1016/S0749-3797(01)00260-4
DO - 10.1016/S0749-3797(01)00260-4
M3 - Article
C2 - 11306230
AN - SCOPUS:0035316628
SN - 0749-3797
VL - 20
SP - 36
EP - 43
JO - American journal of preventive medicine
JF - American journal of preventive medicine
IS - 3 SUPPL.
ER -