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The Appropriate Role Of Cost-Effectiveness In Determining Device Coverage: A Case Study Of Drug-Eluting Stents
Brian Garriock Firth,
Liesl M. Cooper and
Steve Fearn
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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H. E. Smith, J. A. Rihn, D. S. Brodke, R. Guyer, D. Coric, B. Lonner, A. P. Shelokov, B. L. Currier, L. Riley, F. M. Phillips, et al.
Spine Care: Evaluation of the Efficacy and Cost of Emerging Technology
American Journal of Medical Quality,
November 1, 2009;
24(6_suppl):
25S - 31S.
[Abstract]
[PDF]
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