Distributional Cost-Effectiveness Analysis: A Tutorial

doi:10.1177/0272989X15583266

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Distributional Cost-Effectiveness Analysis: A Tutorial

2015-04-23

142

Miqdad Asaria *

Susan Griffin

Cookson, Richard

DOI：10.1177/0272989X15583266

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Abstract

En 中文

Distributional cost-effectiveness analysis (DCEA) is a framework for incorporating health inequality concerns into the economic evaluation of health sector interventions. In this tutorial, we describe the technical details of how to conduct DCEA, using an illustrative example comparing alternative ways of implementing the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). The 2 key stages in DCEA are 1) modeling social distributions of health associated with different interventions, and 2) evaluating social distributions of health with respect to the dual objectives of improving total population health and reducing unfair health inequality. As well as describing the technical methods used, we also identify the data requirements and the social value judgments that have to be made. Finally, we demonstrate the use of sensitivity analyses to explore the impacts of alternative modeling assumptions and social value judgments.

Keywords:

cost-effectiveness analysis

economic evaluation

efficiency

equality

equity

fairness

health distribution

health inequality

inequality measures

opportunity cost

social value judgments

social welfare functions

tradeoff

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