Incorporating Future Costs in Medical Cost-Effectiveness Analysis: Implications for the Cost-Effectiveness of the Treatment

It has been shown that the difference between consumption and production during life years gained should be included as a cost in cost-effectiveness analysis. In this study the authors estimate the impact of including these future costs on the cost-effective-ness of the treatment of hypertension in Sweden. The cost per quality-adjusted life year (QALY) gained changes little among young men and women due to the addition of future costs, but increases by about $14,000 for middle-aged men and women and about $27,000 for older men and women. When future costs are not included, the cost per QALY gained is generally lowest among older men and women, but when future costs are included, the cost per QALY gained is generally lowest among middle-aged men and women. The authors conclude that the total resource consequences of changes in mortality should be routinely considered in cost-effectiveness analyses. Key words: Cost-effectiveness analysis; economic evaluation; costs; societal per-spective. (Med Decis Making 1997;17:382-389) The rapid growth of health care expenditures has led to increased interest in the economic evaluatio