IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2023i5p4637-d1088940.html
   My bibliography  Save this article

Cost-Benefit Analysis versus Cost-Effectiveness Analysis from a Societal Perspective in Healthcare

Author

Listed:
  • Robert J. Brent

    (Department of Economics, Fordham University, Bronx, NY 10458, USA)

Abstract

Cost-effectiveness analysis (CEA) is the main way that economic evaluations are carried out in the health care field. However, CEA has limited validity in deciding whether any health care evaluation is socially worthwhile and hence justifies funding. Cost-Benefit Analysis (CBA) is the economic evaluation method that should be used to help decide what to invest in when the objective is to record the impact on everyone in society. Cost-utility analysis (CUA), which has its roots in CEA, can be converted into CBA under certain circumstances that are not general. In this article, the strengths and weaknesses of CEA relative to CBA are analyzed in stages, starting in its most classical form and then proceeding via CUA to end up as CBA. The analysis takes place mainly in the context of five actual dementia interventions that have already been found to pass a CBA test. The CBA data is recast into CEA and CUA terms in tabular form in order that the contrast been CEA and CBA is most transparent. We find that how much of the fixed budget that is used up to fund other alternatives determines how much is left over to fund the particular intervention one is evaluating.

Suggested Citation

  • Robert J. Brent, 2023. "Cost-Benefit Analysis versus Cost-Effectiveness Analysis from a Societal Perspective in Healthcare," IJERPH, MDPI, vol. 20(5), pages 1-12, March.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:5:p:4637-:d:1088940
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/5/4637/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/20/5/4637/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Joseph E. Aldy & W. Kip Viscusi, 2008. "Adjusting the Value of a Statistical Life for Age and Cohort Effects," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 573-581, August.
    2. Pei-Jung Lin & Brittany D’Cruz & Ashley A. Leech & Peter J. Neumann & Myrlene Sanon Aigbogun & Dorothee Oberdhan & Tara A. Lavelle, 2019. "Family and Caregiver Spillover Effects in Cost-Utility Analyses of Alzheimer’s Disease Interventions," PharmacoEconomics, Springer, vol. 37(4), pages 597-608, April.
    3. Johannesson, Magnus, 1995. "The relationship between cost-effectiveness analysis and cost-benefit analysis," Social Science & Medicine, Elsevier, vol. 41(4), pages 483-489, August.
    4. Robert Brent, 2011. "An implicit price of a DALY for use in a cost-benefit analysis of ARVs," Applied Economics, Taylor & Francis Journals, vol. 43(11), pages 1413-1421.
    5. Brent, Robert J., 1991. "A new approach to valuing a life," Journal of Public Economics, Elsevier, vol. 44(2), pages 165-171, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. De Donder, Philippe & Bardey, David & Zaporozhets, Vera, 2024. "The Health Technology Assessment Approach of the Economic Value of Diagnostic Tests - A Literature Review," TSE Working Papers 24-1508, Toulouse School of Economics (TSE).
    2. Bardey, David & De Donder , Philippe & Zaporozhets , Vera, 2024. "The Health Technology Assessment Approach of The Economic Value of Diagnostic Test: A Literature Review," Documentos CEDE 21041, Universidad de los Andes, Facultad de Economía, CEDE.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. Robert J. Brent, 2010. "Setting Priorities for HIV/AIDS Interventions," Books, Edward Elgar Publishing, number 12742.
    3. Ryan Edwards, 2013. "The cost of uncertain life span," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(4), pages 1485-1522, October.
    4. James K. Hammitt, 2020. "Valuing mortality risk in the time of COVID-19," Journal of Risk and Uncertainty, Springer, vol. 61(2), pages 129-154, October.
    5. Moreno Gigi & van Eijndhoven Emma & Benner Jennifer & Sullivan Jeffrey, 2017. "The Long-Term Impact of Price Controls in Medicare Part D," Forum for Health Economics & Policy, De Gruyter, vol. 20(2), pages 1-56, December.
    6. Kuhn, Michael & Frankovic, Ivan & Wrzaczek, Stefan, 2017. "Medical Progress, Demand for Health Care, and Economic Performance," VfS Annual Conference 2017 (Vienna): Alternative Structures for Money and Banking 168249, Verein für Socialpolitik / German Economic Association.
    7. Anna Scherbina, 2021. "Assessing the Optimality of a COVID Lockdown in the United States," Economics of Disasters and Climate Change, Springer, vol. 5(2), pages 177-201, July.
    8. Zahran, Sammy & Iverson, Terrence & McElmurry, Shawn P. & Weiler, Stephan & Levitt, Ryan, 2019. "Hidden Costs of Blight and Arson in Detroit: Evidence From a Natural Experiment in Devil's Night," Ecological Economics, Elsevier, vol. 157(C), pages 266-277.
    9. Martin Gaynor & Nirav Mehta & Seth Richards-Shubik, 2023. "Optimal Contracting with Altruistic Agents: Medicare Payments for Dialysis Drugs," American Economic Review, American Economic Association, vol. 113(6), pages 1530-1571, June.
    10. Aldy, Joseph, 2019. "Birds of a Feather: Estimating the Value of Statistical Life from Dual-Earner Families," Working Paper Series rwp19-013, Harvard University, John F. Kennedy School of Government.
    11. Robert J. Brent, 2012. "The Effects Of Hiv Medications On The Quality Of Life Of Older Adults In New York City," Health Economics, John Wiley & Sons, Ltd., vol. 21(8), pages 967-976, August.
    12. Herrera-Araujo, Daniel & Rochaix, Lise, 2020. "Does the Value per Statistical Life vary with age or baseline health? Evidence from a compensating wage study in France," Journal of Environmental Economics and Management, Elsevier, vol. 103(C).
    13. Patrick Carlin & Brian E. Dixon & Kosali I. Simon & Ryan Sullivan & Coady Wing, 2022. "How Undervalued is the Covid-19 Vaccine? Evidence from Discrete Choice Experiments and VSL Benchmarks," NBER Working Papers 30118, National Bureau of Economic Research, Inc.
    14. Antoine Bommier & Bertrand Villeneuve, 2012. "Risk Aversion and the Value of Risk to Life," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 79(1), pages 77-104, March.
    15. Richards-Shubik, Seth & Roberts, Mark S. & Donohue, Julie M., 2022. "Measuring quality effects in equilibrium," Journal of Health Economics, Elsevier, vol. 83(C).
    16. Hala Abou-Ali & Hesham El-Azony & Heba El-Laithy & Jonathan Haughton & Shahid Khandker, 2010. "Evaluating the impact of Egyptian Social Fund for Development programmes," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 2(4), pages 521-555.
    17. 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.
    18. Pretnar, Nick, 2020. "The Intergenerational Welfare Implications of Disease Contagion," MPRA Paper 101862, University Library of Munich, Germany, revised 14 Jul 2020.
    19. Kevin Haninger & James K. Hammitt, 2011. "Diminishing Willingness to Pay per Quality‐Adjusted Life Year: Valuing Acute Foodborne Illness," Risk Analysis, John Wiley & Sons, vol. 31(9), pages 1363-1380, September.
    20. Stephen C. Newbold, 2011. "Valuing Health Risk Changes Using a Life-Cycle Consumption Framework," NCEE Working Paper Series 201103, National Center for Environmental Economics, U.S. Environmental Protection Agency, revised Apr 2011.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:20:y:2023:i:5:p:4637-:d:1088940. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.