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The relationship between cost-effectiveness analysis and cost-benefit analysis

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  • Johannesson, Magnus

Abstract

This paper examines the relationship between cost-effectiveness analysis and cost-benefit analysis. Provided that a cost-effectiveness analysis includes all the relevant societal costs, it is shown that a cost-effectiveness analysis can be interpreted as a cost-benefit analysis where the willingness to pay per effectiveness unit is assumed to be constant and the same for everyone. To relax this assumption the willingness to pay per effectiveness unit can be allowed to vary depending on for instance the size of the health effects and the target population. It is argued that cost-effectiveness analysis is best viewed as a subset of cost-benefit analysis, where the aim of the analysis is to estimate the cost function of producing health effects. It is also concluded that to interpret and use cost-effectiveness analysis as a tool to maximize the health effects for one specified real-world budget, will be inconsistent with a societal perspective and is likely to lead to major problems of suboptimization.

Suggested Citation

  • Johannesson, Magnus, 1995. "The relationship between cost-effectiveness analysis and cost-benefit analysis," Social Science & Medicine, Elsevier, vol. 41(4), pages 483-489, August.
  • Handle: RePEc:eee:socmed:v:41:y:1995:i:4:p:483-489
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    Cited by:

    1. Pinto-Prades, Jose Luis & Loomes, Graham & Brey, Raul, 2009. "Trying to estimate a monetary value for the QALY," Journal of Health Economics, Elsevier, vol. 28(3), pages 553-562, May.
    2. Stephen Birch & Amiram Gafni, 2012. "Decision Rules in Economic Evaluation Revisited," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 49 Edward Elgar Publishing.
    3. Dolan, Paul & Edlin, Richard, 2002. "Is it really possible to build a bridge between cost-benefit analysis and cost-effectiveness analysis?," Journal of Health Economics, Elsevier, vol. 21(5), pages 827-843, September.
    4. Dionne, Georges & Lebeau, Martin, 2010. "Le calcul de la valeur statistique d’une vie humaine," L'Actualité Economique, Société Canadienne de Science Economique, vol. 86(4), pages 487-530, décembre.
    5. Gre[ss], Stefan & Niebuhr, Dea & Rothgang, Heinz & Wasem, Jurgen, 2005. "Criteria and procedures for determining benefit packages in health care: A comparative perspective," Health Policy, Elsevier, vol. 73(1), pages 78-91, July.
    6. Hultkrantz, Lars & Svensson, Mikael, 2012. "A Comparison of Benefit Cost and Cost Utility Analysis in Practice: Divergent Policies in Sweden," Karlstad University Working Papers in Economics 1, Karlstad University, Department of Economics.
    7. James Hammitt, 2013. "Admissible utility functions for health, longevity, and wealth: integrating monetary and life-year measures," Journal of Risk and Uncertainty, Springer, vol. 47(3), pages 311-325, December.
    8. Gafni, Amiram & Birch, Stephen, 2006. "Incremental cost-effectiveness ratios (ICERs): The silence of the lambda," Social Science & Medicine, Elsevier, vol. 62(9), pages 2091-2100, May.
    9. Karl Claxton & Simon Walker & Steven Palmer & Mark Sculpher, 2010. "Appropriate Perspectives for Health Care Decisions," Working Papers 054cherp, Centre for Health Economics, University of York.
    10. Sumper, Andreas & Boix-Aragonès, Oriol & Villafáfila-Robles, Roberto & Bergas-Jané, Joan & Ramírez-Pisco, Rodrigo, 2010. "Methodology for the assessment of the impact of existing high voltage lines in urban areas," Energy Policy, Elsevier, vol. 38(10), pages 6036-6044, October.
    11. Smith, Richard D. & Richardson, Jeff, 2005. "Can we estimate the `social' value of a QALY?: Four core issues to resolve," Health Policy, Elsevier, vol. 74(1), pages 77-84, September.
    12. Joanne Lord & George Laking & Alastair Fischer, 2006. "Non-linearity in the cost-effectiveness frontier," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 565-577.
    13. David Canning, 2007. "Valuing Lives Equally and Welfare Economics," PGDA Working Papers 2707, Program on the Global Demography of Aging.
    14. David Canning, 2013. "Axiomatic Foundations For Cost‐Effectiveness Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1405-1416, December.
    15. Hammitt, James & Haninger, Kevin, 2010. "Diminishing Willingness to Pay per Quality-Adjusted Life Year: Valuing Acute Foodborne Illness," LERNA Working Papers 11.01.335, LERNA, University of Toulouse.
    16. Johannesson, Magnus & O'Conor, Richard M., 1997. "Cost-utility analysis from a societal perspective," Health Policy, Elsevier, vol. 39(3), pages 241-253, March.
    17. Henrik Andersson & James K. Hammitt & Kristian Sundström, 2015. "Willingness to Pay and QALYs: What Can We Learn about Valuing Foodborne Risk?," Journal of Agricultural Economics, Wiley Blackwell, vol. 66(3), pages 727-752, September.
    18. Carmen Herrero & Juan D. Moreno-Ternero, 2009. "Estimating production costs in the economic evaluation of health-care programs," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 21-35.
    19. Helen Mason & Michael Jones-Lee & Cam Donaldson, 2009. "Modelling the monetary value of a QALY: a new approach based on UK data," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 933-950.
    20. Liqun Liu & Andrew J. Rettenmaier & Thomas R. Saving, 2008. "Longevity bias in cost-effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 17(4), pages 523-534.
    21. repec:ohe:monogr:000464 is not listed on IDEAS
    22. Robinson, Angela & Gyrd-Hansen, Dorte & Bacon, Philomena & Baker, Rachel & Pennington, Mark & Donaldson, Cam, 2013. "Estimating a WTP-based value of a QALY: The ‘chained’ approach," Social Science & Medicine, Elsevier, vol. 92(C), pages 92-104.
    23. Powdthavee, Nattavudh & van den Berg, Bernard, 2011. "Putting different price tags on the same health condition: Re-evaluating the well-being valuation approach," Journal of Health Economics, Elsevier, vol. 30(5), pages 1032-1043.

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