Fenwick, E., O'Brien, B.J. and Briggs, A. (2004) Cost-effectiveness acceptability curves - facts, fallacies and frequently asked questions. Health Economics, 13(5), pp. 405-415. (doi: 10.1002/hec.903)
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Publisher's URL: http://dx.doi.org/10.1002/hec.903
Abstract
Cost-effectiveness acceptability curves (CEACs) have been widely adopted as a method to quantify and graphically represent uncertainty in economic evaluation studies of health-care technologies. However, there remain some common fallacies regarding the nature and shape of CEACs that largely result from the textbook illustration of the CEAC. This textbook CEAC shows a smooth curve starting at probability 0, with an asymptote to 1 for higher money values of the health outcome (). But this familiar ogive shape which makes the textbook CEAC look like a cumulative distribution function is just one special case of the CEAC. The reality is that the CEAC can take many shapes and turns because it is a graphic transformation from the cost-effectiveness plane, where the joint density of incremental costs and effects may straddle quadrants with attendant discontinuities and asymptotes. In fact CEACs: (i) do not have to cut the y-axis at 0; (ii) do not have to asymptote to 1; (iii) are not always monotonically increasing in ; and (iv) do not represent cumulative distribution functions (cdfs). Within this paper we present a gallery of CEACs in order to identify the fallacies and illustrate the facts surrounding the CEAC. The aim of the paper is to serve as a reference tool to accompany the increased use of CEACs within major medical journals.
Item Type: | Articles |
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Keywords: | cost-effectiveness acceptability curves, uncertainty, cost-effectiveness planes, decision-making |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Fenwick, Professor Elisabeth |
Authors: | Fenwick, E., O'Brien, B.J., and Briggs, A. |
Subjects: | R Medicine > RA Public aspects of medicine R Medicine > R Medicine (General) H Social Sciences > HG Finance |
College/School: | College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Centre for Population and Health Sciences College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment |
Journal Name: | Health Economics |
Publisher: | John Wiley and Sons Ltd. |
ISSN: | 1057-9230 |
Copyright Holders: | Copyright © 2004 John Wiley and Sons Ltd. |
First Published: | First published in Health Economics 13(5):405-415 |
Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
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