Representing uncertainty: the role of cost-effectiveness acceptability curves

Health Econ. 2001 Dec;10(8):779-87. doi: 10.1002/hec.635.


Decision-making in health care is inevitably undertaken in a context of uncertainty concerning the effectiveness and costs of health care interventions and programmes. One method that has been suggested to represent this uncertainty is the cost-effectiveness acceptability curve. This technique, which directly addresses the decision-making problem, has advantages over confidence interval estimation for incremental cost-effectiveness ratios. However, despite these advantages, cost-effectiveness acceptability curves have yet to be widely adopted within the field of economic evaluation of health care technologies. In this paper we consider the relationship between cost-effectiveness acceptability curves and decision-making in health care, suggest the introduction of a new concept more relevant to decision-making, that of the cost-effectiveness frontier, and clarify the use of these techniques when considering decisions involving multiple interventions. We hope that as a result we can encourage the greater use of these techniques.

MeSH terms

  • Confidence Intervals
  • Cost-Benefit Analysis*
  • Data Interpretation, Statistical
  • Decision Making*
  • Humans
  • Models, Econometric
  • Quality-Adjusted Life Years
  • Technology Assessment, Biomedical / economics
  • Technology Assessment, Biomedical / methods*