This Article  • References  • 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  • Similar articles in JAMA  Social Bookmarking   What's this?

Aaron A. Stinnett, PhD
Johnson & Johnson Raritan, NJ

John Mullahy, PhD
University of Wisconsin-Madison Medical School

JAMA. 1997;277(24):1931-1932.

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

To the Editor.

—We agree with Drs Sacristán and Obenchain¹ that careful analysis of uncertainty is an essential element of sound pharmacoeconomic evaluations. However, their suggestion that a confidence interval (CI) should be reported for the cost-effectiveness (C/E) ratio of an intervention having a significant probability of a negative C/E ratio may prove problematic in applications.

Most troubling is the fact that the magnitude of a negative C/E ratio—defined as the ratio of incremental cost (AC) to incremental effectiveness (E)—conveys no useful information. For example, it is clear that an estimate of AC =-100, E =100 is more favorable than an estimate of AC =-100, E=50, which in turn is more favorable than an estimate of AC=-50, E=50. However, this implies that a C/E ratio of-1 (-100/100) is preferable to a ratio of -2 (-100/50), and yet a ratio of-2 (-100/50) is preferable to a ratio of -1 (-50/50). . . . [Full Text PDF of this Article]

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