This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Medical Practice  • Medical Practice, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Wynia is correct that CEA is often complex and limited and may be sensitive to small changes in its inputs or structure. For years, persons advocating a straightforward reckoning of the marginal benefits and costs of new medical innovations have faced complaints that CEA is not up to the task.¹ That is why the lessons to be learned from NICE are so germane to US sensibilities. Cost-effectiveness analysis is not more technically sound or reliable on the other side of the Atlantic. Yet NICE uses it as the cornerstone of its guidance and has withstood the resulting industry and political pressures. No one can say, however, that NICE has worshipped blindly at the idol of economic modeling. Great effort goes into independent dissection of the nuances of economic models to understand their limitations, and deep thought and transparent discussion are applied to the social values that may . . . [Full Text of this Article]

Steven D. Pearson, MD, MSc
spearson99@yahoo.com
Department of Ambulatory Care and Prevention
Harvard Medical School
Boston, Mass

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Cost-effectiveness Analysis in the United States
Matthew Wynia
JAMA. 2006;295(23):2722.
EXTRACT | FULL TEXT