Use and Misuse of the Term `cost Effective' in Medicine
Weinstein, Milton C.
McNeil, Barbara J.
New England Journal of Medicine. 1986 Jan 23; 314(4): 253-256.
Mounting pressure to stem the rise in national health care expenditures has led to the popularization of the term "cost effective." Frequently no explicit data are presented to document savings, and the varied uses of the term do not always permit unambiguous identification of a single strategy as the most cost effective. Four criteria for cost effectiveness often used in the literature are (1) cost effective equals cost saving, (2) cost effective equals effective, (3) cost effective equals cost saving with an equal or better health outcome, and (4) cost effective equals having an additional benefit worth the additional cost. The authors argue that the term should be restricted to cases in which criterion (4) applies. Terminological misconceptions are discussed through specific examples, and it is contended that many medical choices are influenced by non-monetary values. (KIE abstract)
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