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Journal of the American Academy of Dermatology
Volume 46, n° 2
pages 271-283 (février 2002)
Doi : 10.1067/mjd.2002.119566
Economic analysis in dermatology
 

Charles N. Ellis, MD a, Kristin L. Reiter, MAE b, John R.C. Wheeler, PhD b, A.Mark Fendrick, MD b, c
a Department of Dermatology, University of Michigan Medical School and Dermatology Service, Department of Veterans Affairs, Ann Arbor Healthcare System Ann Arbor, Michigan 
b Michigan Health Services Research and the Department of Health Management and Policy, University of Michigan School of Public Health Ann Arbor, Michigan 
c Division of General Medicine, Department of Internal Medicine and Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies (CHOICES), University of Michigan School of Medicine. Ann Arbor, Michigan 

Abstract

Cost-effectiveness studies are rising in importance as means for justifying expenditures on health interventions and as guides for making treatment and resource allocation decisions. However, the term “cost-effective” often is used erroneously, attributed to therapies that have not been subjected to rigorous cost analysis or comparison to an appropriate alternative. Health economic studies include cost-of-illness, cost-minimization, cost-effectiveness, cost-utility, and cost-benefit analyses. Each of these types of analyses differs in what it measures and under what circumstances its use is appropriate. This article describes the different types of economic studies, using examples to highlight their key features, and provides a summary of the key components of an economic analysis including perspective, cost and outcomes measurement, time horizon, cost-discounting, and sensitivity analysis. (J Am Acad Dermatol 2002;46:271-83.)

The full text of this article is available in PDF format.

 Ms Reiter is a doctoral student in Health Services Organization and Policy in the University of Michigan School of Public Health.
 Reprint requests: Charles N. Ellis, MD, Department of Dermatology, 1910 A. Alfred Taubman Center, University of Michigan Medical School, Ann Arbor, MI 48109-0314.

*  *As used here, the term cost-effectiveness analysis refers to a specific type of cost analysis; the phrase also is used as a general term for various economic analyses.
  The term incremental refers to the difference in overall cost-effectiveness of one treatment compared with another treatment or to doing nothing. The term marginal cost-effectiveness describes one type of incremental difference, namely the difference in cost-effectiveness when adjusting the treatment by one unit in intensity (eg, increasing the dosage) at a single point in the range of the cost-effectiveness comparison.10 The term marginal is sometimes used synonymously with incremental , but this is not recommended.10 For example, some cost-effectiveness analyses are designed to identify the optimal level of administration of a particular therapy, for example, the optimal dosage of a systemic therapy to get the most outcome per dollar spent. Such an analysis would seek to determine the ratios of outcome to cost for various dosages, thereby identifying the incremental cost-effectiveness of successively higher dosage levels (ie, the marginal cost-effectiveness of increasing the dose).


© 2002  American Academy of Dermatology, Inc. Published by Elsevier Masson SAS@@#104157@@
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