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- Title
Formal response to 'Determining the optimal combinations of mutually exclusive interventions: a response to Hutubessy and colleagues.'
- Authors
Baltussen, Rob M. P. M.; Hutubessy, Raymond C. W.; Barendregt, Jan J.; Evans, David B.; Murray, Christopher J. L.
- Abstract
The article presents a response to the paper 'Determining the Optimal Combinations of Mutually Exclusive Interventions.' The author argues that the use of stochastic league tables to guide allocation decisions in health care can lead to potential inefficiencies through the dependence of the probabilities of inclusion on decisions related to other programs and the failure to consider the opportunity costs of obtaining increased health benefits. As an alternative, the author proposes the net monetary benefit approach to overcome both criticisms. The paper suggests that the probabilities of inclusion of interventions are independent of each other. The costs and effectiveness of combinations of interventions that interact on the cost or effectiveness side are modelled jointly. In this case, the probability of including combinations of interventions that interact is estimated rather than the probability of including the components individually. The paper also discusses the failure to consider a shadow price for a unit of benefit and thus ignore the opportunity cost of funding decisions. This is not a criticism of stochastic league tables but of cost-effectiveness analysis as a whole.
- Subjects
HEALTH services administration; MEDICAL care; MEDICAL economics; COST effectiveness
- Publication
Health Economics, 2003, Vol 12, Issue 2, p163
- ISSN
1057-9230
- Publication type
Article
- DOI
10.1002/hec.716