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Jonathan T. Edelson, MD
Health Information Designs, Inc Arlington, Va

Anna N. A. Tosteson, ScD
Brigham and Women's Hospital Boston, Mass

JAMA. 1991;265(5):594-595.

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

In Reply.—

We appreciate the thoughtful comments of Drs Hillman and Bloom, Dr Roth, and Mr Jacobs. We agree with Dr Roth and Drs Hillman and Bloom that measures of cost-effectiveness other than cost per YOLS are useful; we provided two such measures in our study¹ as cost per any bleeding and cost per fatal bleeding event. However, cost per YOLS is the standard measure in the field, allowing policymakers to make meaningful comparisons by using the same metric across disparate therapies competing for the same scarce resources. Thus, we believe it is appropriately the central measure of our cost-effectiveness analysis. Effectiveness measures were matched with costs. In our analysis, YOLSs were derived from the remaining life expectancy associated with only those deaths prevented in the 1-year time period of misoprostol therapy.

We share Dr Roth's and Drs Hillman and Bloom's concern that patients with "nonbleeding" ulcers be included . . . [Full Text PDF of this Article]

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