JSM 2004 - Toronto

Abstract #300650

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Activity Number: 109
Type: Topic Contributed
Date/Time: Monday, August 9, 2004 : 10:30 AM to 12:20 PM
Sponsor: Section on Health Policy Statistics
Abstract - #300650
Title: The Cost-effectiveness Acceptability Curve--Leaving the Planes, Heading for the Frontier
Author(s): Elisabeth Fenwick*+
Companies: University of York
Address: Dept. of Economics and Related Studies, York, International, YO10 5DD, United Kingdom
Keywords: cost-effectiveness plane ; statistical cost-effectiveness analysis ; cost-effectiveness acceptability curve ; decision-making
Abstract:

Within the last 10 years, cost-effectiveness acceptability curves (CEACs) have been introduced and widely adopted within economic evaluation of health care technologies. They provide a visual impression of the joint uncertainty in the single dimension of the decision space. In particular, they overcome the particular problems associated with estimating confidence intervals for cost-effectiveness ratios. However, despite appearing in all of the major medical journals, some issues still surround the use of CEACs within health care decision-making. Firstly, there are common fallacies regarding the nature and shape of CEACs, which largely result from the "textbook" illustrations of CEACs. The reality is that the CEAC, as a graphical transformation of the cost-effectiveness plane, can take many shapes and turns depending upon the location of the joint density of incremental cost and effects within the plane. Secondly, there is confusion regarding the role that CEACs fulfil within the context of expected value decision-making. The assessment of decision uncertainty, as provided by CEACs, is a vital first step towards valuing the worth of collecting further information.

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Revised March 2004