Economics of healthcare | |
Making choices in health: WHO guide to cost-effectiveness analysis. |
Australia is the world leader in using cost-effectiveness analysis in healthcare, with its application to pharmaceuticals (Pharmaceutical Benefits Scheme) starting in the early 1990s, medical/diagnostic procedures (Medical Benefits Scheme) in the late 1990s and medical devices (Schedule Five) at the start of this decade. But how much does the average medical practitioner need to know about cost-effectiveness analysis? The three hundred-plus pages of Making choices in health is written for practising health economists, policymakers and researchers and it is not light reading. It is divided into two parts: Methods for generalized cost-effectiveness analysis and Background papers and applications. It is intended as a set of guidelines on cost-effectiveness analysis (CEA) to complement existing guidelines. It proposes to cover the use of CEA on existing medical interventions (as opposed to new medical interventions) under the name of generalised CEA (GCEA). Basically, it is looking at what could be achieved if we could start from scratch to build a health-care system (ie, reallocate all healthcare resources). Disappointingly, the background papers have all been published before in various journals. Even more disappointing is the lack of Australian contributions and the failure to address the lack of available data when applying cost-effectiveness analysis, let alone generalised CAE, in the real world of medical practice. This book claims to propose a standard set of methodological choices on how to perform generalised CEA to enhance the comparability and generalisability of results. There is still a world of difference between theory and practice in a world that is desperate for practical solutions. Despite the widespread application and impact of the cost-effectiveness analysis tool to all new medical interventions in Australia, even medical practitioners who have had direct involvement in the application of CEA to a pharmaceutical or medical procedure/device may find this publication heavy going. Although informative and having a worthwhile objective, this book is not intended as suitable reading for medical practitioners. Susanne P O’Malley
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