On the margins of health economics: a response to 'resolving NICE'S nasty dilemma'.

Publisher: Cambridge University Press Country of Publication: England NLM ID: 101247224 Publication Model: Print Cited Medium: Internet ISSN: 1744-134X (Electronic) Linking ISSN: 17441331 NLM ISO Abbreviation: Health Econ Policy Law Subsets: MEDLINE

Original Publication: Cambridge : Cambridge University Press, c2006-

Advisory Committees* ; Economics* ; Quality-Adjusted Life Years*; Humans

In a 2011 article published in this journal, Baker et al. set out to resolve a nasty dilemma for NICE by reconciling two approaches for determining whether adopting a new intervention would increase total health gains produced from available resources and hence increase system efficiency. In this response we show how the proposed reconciliation, as well as the two approaches on which it is based, fail to inform decision makers about the efficiency of a new intervention. We show how this arises from the misuse of incremental costs and effects of between-intervention comparisons as measures of changes in costs and effects associated with marginal adjustments to the scale of an intervention. Ironically, incremental data represent the choices faced by decision makers and we illustrate a method for determining unambiguously whether a new intervention represents an improvement in efficiency.

Comment on: Health Econ Policy Law. 2011 Oct;6(4):435-47. (PMID: 21854688)

Date Created: 20150310 Date Completed: 20150511 Latest Revision: 20181202

20231215

10.1017/S1744133114000462

25747196