Economic Evaluation of Health Care Interventions:

Concerns are often expressed about the failure of health care decision-makers at different levels of decision making to utilize the substantial literature on the cost-effectiveness of health care interventions. A recent survey of pharmaconomic assessment in 11 OECD countries reported that just under half of these countries use the technique of cost-effectiveness analysis (CEA) to determine the “value-for-money ” of new pharmaceuticals. However, for several of these countries as well as others (including Australia and the province of Ontario, Canada) systems for integrating cost effectiveness information into reimbursement decisions have been in place for over a decade. On the other hands it has been argued that decision makers should maintain a healthy skepticism about the results of cost-effectiveness analysis and the usefulness of this information in purchasing and planning decisions. Based on the experience to date in many jurisdictions it seems that one can determine if the perceived lack of usefulness of this methodology and literature is real. In other words, do we have evidence to demonstrate that the use of cost effectiveness analysis has helped those who used it to achieve their stated goals? If not, is this lack of usefulness due to flaws in the economic methods themselves or whether it is the result of the departure of the current CE methodology from the economics discipline as well as a failure to address the decision makers ’ problems