BMJ 1999;319:635-638 ( 4 September )

Education and debate

Methods in health service research

Handling uncertainty in economic evaluations of healthcare interventions

This is the last of four articles

Andrew H Briggs, training fellow,  Alastair M Gray, reader. 

Health Economics Research Centre, Institute of Health Sciences, University of Oxford, Oxford OX3 7LF

Correspondence to: A H Briggs andrew.briggs@his.ox.ac.uk

The first 150 words of the full text of this article appear below.

The constant introduction of new health technologies, coupled with limited healthcare resources, has engendered a growing interest in economic evaluation as a way of guiding decision makers towards interventions that are likely to offer maximum health gain. In particular, cost effectiveness analyseswhich compare interventions in terms of the extra or incremental cost per unit of health outcome obtainedhave become increasingly familiar in many medical and health service journals.

Considerable uncertainty exists in regard to valid economic evaluations. Firstly, several aspects of the underlying methodological framework are still being debated among health economists. Secondly, there is often considerable uncertainty surrounding the data, the assumptions that may have been used, and how to handle and express this uncertainty. In the absence of data at the patient level sensitivity analysis is commonly used; however, a number of alternative methods of sensitivity analysis exist, with different implications for the interval estimates generated . . . [Full text of this article]

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