Health Affairs, 27, no. 6 (2008): 1577-1586 doi: 10.1377/hlthaff.27.6.1577 © 2008 by Project HOPE	New Online   House Health Reform Bill   Paying for Reform   Vetting AHIP's Report   HIV/AIDS Costs   Brief: Insurance Reform   HA Blog Top 10

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Medical Devices

The Appropriate Role Of Cost-Effectiveness In Determining Device Coverage: A Case Study Of Drug-Eluting Stents

The use of incremental cost-effectiveness ratios based on quality-adjusted life-years (QALYs) as a critical determinant of what should be covered by a health system is a growing trend. This presents challenges when applied to rapidly evolving technologies. The case study here focuses on the example of drug-eluting stents and the four-year change in cost-effectiveness as determined by the U.K. National Institute for Health and Clinical Excellence (NICE). We contend that classic cost-effectiveness as a blunt instrument for determining what should be covered may lead to erroneous conclusions when a broader perspective and the impact on health outcomes and costs are considered.

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