Opportunity costs and uncertainty in the economic evaluation of health care interventions

Health Econ. 2002 Jan;11(1):23-31. doi: 10.1002/hec.641.


Considerable methodological research has been conducted on handling uncertainty in cost-effectiveness analysis. The current literature suggests the concepts of net health benefits and cost-effectiveness acceptability curves to circumvent the technical shortcomings of cost-effectiveness ratio statistics. However, these approaches do not provide a solution for the inherent problem that the threshold cost-effectiveness ratio itself is unknown. The authors suggest analysing uncertainty in cost-effectiveness analysis by directly addressing the concept of opportunity costs using the decision rule described by Birch and Gafni (1992) and introduce a new graphical framework (the "decision making plane") for communicating with policy makers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Budgets
  • Cost of Illness
  • Cost-Benefit Analysis / methods
  • Cost-Benefit Analysis / statistics & numerical data*
  • Decision Making, Organizational*
  • HIV Infections / economics
  • HIV Infections / therapy
  • Health Care Costs
  • Health Care Rationing / economics*
  • Health Care Rationing / methods
  • Humans
  • Models, Econometric
  • Policy Making
  • Program Evaluation / economics
  • Program Evaluation / methods