IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v13y2004i5p405-415.html
   My bibliography  Save this article

Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions

Author

Listed:
  • Elisabeth Fenwick
  • Bernie J. O'Brien
  • Andrew Briggs

Abstract

Cost‐effectiveness acceptability curves (CEACs) have been widely adopted as a method to quantify and graphically represent uncertainty in economic evaluation studies of health‐care technologies. However, there remain some common fallacies regarding the nature and shape of CEACs that largely result from the ‘textbook’ illustration of the CEAC. This ‘textbook’ CEAC shows a smooth curve starting at probability 0, with an asymptote to 1 for higher money values of the health outcome (λ). But this familiar ‘ogive’ shape which makes the ‘textbook’ CEAC look like a cumulative distribution function is just one special case of the CEAC. The reality is that the CEAC can take many shapes and turns because it is a graphic transformation from the cost‐effectiveness plane, where the joint density of incremental costs and effects may ‘straddle’ quadrants with attendant discontinuities and asymptotes. In fact CEACs: (i) do not have to cut the y‐axis at 0; (ii) do not have to asymptote to 1; (iii) are not always monotonically increasing in λ; and (iv) do not represent cumulative distribution functions (cdfs). Within this paper we present a ‘gallery’ of CEACs in order to identify the fallacies and illustrate the facts surrounding the CEAC. The aim of the paper is to serve as a reference tool to accompany the increased use of CEACs within major medical journals. Copyright © 2004 John Wiley & Sons, Ltd.

Suggested Citation

  • Elisabeth Fenwick & Bernie J. O'Brien & Andrew Briggs, 2004. "Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions," Health Economics, John Wiley & Sons, Ltd., vol. 13(5), pages 405-415, May.
  • Handle: RePEc:wly:hlthec:v:13:y:2004:i:5:p:405-415
    DOI: 10.1002/hec.903
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.903
    Download Restriction: no

    References listed on IDEAS

    as
    1. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2001. "Representing uncertainty: the role of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 779-787, December.
    2. Bryan R. Luce & Karl Claxton, 1999. "Redefining the analytical approach to pharmacoeconomics," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 187-189, May.
    3. Andrew Briggs & Paul Fenn, 1998. "Confidence intervals or surfaces? Uncertainty on the cost-effectiveness plane," Health Economics, John Wiley & Sons, Ltd., vol. 7(8), pages 723-740.
    4. Elizabeth Fenwick & Karl Claxton & Mark Sculpher & Andrew Briggs, 2000. "Improving the efficiency and relevance of health technology assessent: the role of iterative decision analytic modelling," Working Papers 179chedp, Centre for Health Economics, University of York.
    5. Andrew H. Briggs, 1999. "A Bayesian approach to stochastic cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 257-261, May.
    6. Daniel F. Heitjan & Alan J. Moskowitz & William Whang, 1999. "Bayesian estimation of cost‐effectiveness ratios from clinical trials," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 191-201, May.
    Full references (including those not matched with items on IDEAS)

    More about this item

    Statistics

    Access and download statistics

    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:wly:hlthec:v:13:y:2004:i:5:p:405-415. 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: (Wiley Content Delivery). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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 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.

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.