2.50
Hdl Handle:
http://hdl.handle.net/10541/72650
Title:
Non-linearity in the cost-effectiveness frontier.
Authors:
Lord, Joanne; Laking, George R; Fischer, Alastair
Abstract:
Conventional cost-effectiveness decision rules rely on the assumptions that all health care programmes are divisible and exhibit constant returns to scale for a homogeneous population; hence, the path between adjacent programmes on a cost-effectiveness frontier must be linear. In this paper we build a framework to analyse non-linear 'expansion' paths. We model the impact of two key sources of non-linearity: economies of scale or scope in the production of health care; and prioritisation of patients who are most likely to benefit from more expensive and more effective treatments. We conclude that the expansion path might be linear, convex or concave, depending on the situation. The path might also exhibit vertical discontinuity due to fixed costs or horizontal discontinuity due to indivisibility. The efficiency of resource allocation might be improved by empirical estimation of expansion paths. We discuss the advantages and disadvantages of this approach compared with a standard stratified analysis.
Affiliation:
National Institute for Health and Clinical Excellence (NICE), London, UK. joanne.lord@nice.org.uk
Citation:
Non-linearity in the cost-effectiveness frontier. 2006, 15 (6):565-77 Health Econ
Journal:
Health Economics
Issue Date:
Jun-2006
URI:
http://hdl.handle.net/10541/72650
DOI:
10.1002/hec.1083
PubMed ID:
16416416
Type:
Article
Language:
en
ISSN:
1057-9230
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorLord, Joanne-
dc.contributor.authorLaking, George R-
dc.contributor.authorFischer, Alastair-
dc.date.accessioned2009-07-06T16:57:19Z-
dc.date.available2009-07-06T16:57:19Z-
dc.date.issued2006-06-
dc.identifier.citationNon-linearity in the cost-effectiveness frontier. 2006, 15 (6):565-77 Health Econen
dc.identifier.issn1057-9230-
dc.identifier.pmid16416416-
dc.identifier.doi10.1002/hec.1083-
dc.identifier.urihttp://hdl.handle.net/10541/72650-
dc.description.abstractConventional cost-effectiveness decision rules rely on the assumptions that all health care programmes are divisible and exhibit constant returns to scale for a homogeneous population; hence, the path between adjacent programmes on a cost-effectiveness frontier must be linear. In this paper we build a framework to analyse non-linear 'expansion' paths. We model the impact of two key sources of non-linearity: economies of scale or scope in the production of health care; and prioritisation of patients who are most likely to benefit from more expensive and more effective treatments. We conclude that the expansion path might be linear, convex or concave, depending on the situation. The path might also exhibit vertical discontinuity due to fixed costs or horizontal discontinuity due to indivisibility. The efficiency of resource allocation might be improved by empirical estimation of expansion paths. We discuss the advantages and disadvantages of this approach compared with a standard stratified analysis.en
dc.language.isoenen
dc.subject.meshCost-Benefit Analysis-
dc.subject.meshDelivery of Health Care-
dc.subject.meshGreat Britain-
dc.subject.meshHumans-
dc.subject.meshModels, Econometric-
dc.subject.meshResource Allocation-
dc.subject.meshState Medicine-
dc.titleNon-linearity in the cost-effectiveness frontier.en
dc.typeArticleen
dc.contributor.departmentNational Institute for Health and Clinical Excellence (NICE), London, UK. joanne.lord@nice.org.uken
dc.identifier.journalHealth Economicsen

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