Cost-effectiveness in goal-directed therapy: are the dollars spent worth the value?

Abstract

HEALTHCARE FINANCING has become a fixed agenda of international discussions on health policy. An aging population coupled with an insatiable demand for new and costly medical technology pose an unpredictable challenge for future healthcare funding. 1 Jurd A: Expenditures on healthcare in the UK, 1997-2010. Office for National Statistics. 2012. Available at: www.ons.gov.uk/ons/dcp171766_264293.pdf. Google Scholar , 2 OECD: Health data 2013 (online) Health expenditures, OECD Publishing. Available at: http://www.compareyourcountry.org/health/health-spending-change?cr=oecd&lg=en. Accessed on May 10, 2014 Google Scholar , 3 Anderson G. Frogner B. Johns R. et al. Health care spending and use of information technology in OECD countries. Health Affairs. 2006; 25: 819-831 Google Scholar Under such economic pressure, policymakers are expected to deliver cost-containment solutions for efficient and sustainable healthcare provision. On first sight, this idea seems to conflict with the clinicians’ main concern of delivering comprehensive care to the patients, who then often dismiss the positive effect of careful resource allocation on long-term care provision and, consequently, on the overall good to society. 4 Higgins A. Harris A. Health economic methods: cost-minimization, cost-effectiveness, cost-utility, and cost-benefit evaluation. Crit Care Clin. 2012; 28: 11-24 Google Scholar Cost-effectiveness analysis combines both principles by pooling clinical and economic benefit before suggesting sustainable strategies of effective resource allocation. 5 Weinstein M. Siegel J. Gold M. Recommendations of the Panel on Cost-effectiveness in Health and Medicine. JAMA. 2006; 276: 3353-3358 Google Scholar , 6 Weinstein M. Foundations of cost-effectiveness analysis for health and medical practice. N Engl J Med. 1977; 296: 716-721 Google Scholar , 7 Murray C.J. Evans D.B. Acharya A. et al. Development of WHO guidelines on generalized cost-effectiveness analysis. Health Econ. 2000; 9: 235-251 Google Scholar In this paper, the authors review the available literature on cost-effectiveness analysis and goal-directed therapy (GDT).