From cost-effectiveness information to decision-making on liquid-based cytology: Mind the gap
Objective This paper explores the policy process involved in the production of cost-effectiveness information in the context of both national and local policy-making requirements. We use the decision to implement a new technology for cervical cancer screening (liquid-based cytology) in England as a case study.Methods The analysis traces the initial decision by the National Institute of Health and Clinical Excellence to commission further research before implementing this new technology, the economic data produced as a result, the final decision nationally and the implications for decision-makers locally.Results The paper highlights a number of reasons why there may be a gap between the evidence produced by a cost-effectiveness analysis and the information needs of the decision-maker. For example there are difficulties in estimating whether savings in staff time are realisable. In addition, even after a technology has been deemed cost-effective and is recommended for national implementation, further questions remain at the local level, including identifying the most cost-effective way to implement a technology, and selecting the best supplier.Conclusion In order to make cost-effective implementation decisions, local decision-makers require economic data in addition to that required for the national recommendation, and this deserves recognition and further research.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Locock, Louise & Dopson, Sue & Chambers, David & Gabbay, John, 2001. "Understanding the role of opinion leaders in improving clinical effectiveness," Social Science & Medicine, Elsevier, vol. 53(6), pages 745-757, September.
- Drummond, Michael & Cooke, Jonathan & Walley, Tom, 1997. "Economic evaluation under managed competition: Evidence from the U.K," Social Science & Medicine, Elsevier, vol. 45(4), pages 583-595, August.
- Ross, Jayne, 1995. "The use of economic evaluation in health care: Australian decision makers' perceptions," Health Policy, Elsevier, vol. 31(2), pages 103-110, February.
- Stirling Bryan & Iestyn Williams & Shirley McIver, 2007. "Seeing the NICE side of cost-effectiveness analysis: a qualitative investigation of the use of CEA in NICE technology appraisals," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 179-193.
- Duthie, Tessa & Trueman, Paul & Chancellor, Jeremy & Diez, Lara, 1999. "Research into the use of health economics in decision making in the United Kingdom--Phase II: Is health economics `for good or evil'?," Health Policy, Elsevier, vol. 46(2), pages 143-157, January.
When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:89:y:2009:i:2:p:193-200. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)or ()
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.