[Methods of comparative economic evaluations of therapies and for rational allocation of resources across sectors of health care systems - introduction, advantages, risks]

Abstract

Because of scarcity of resources, diagnostic and therapeutic procedures in medicine increasingly have to be examined not only with regard to effectiveness but also with regard to cost-effectiveness, which means with regard to the relation between resources used and resulting outcome (however this outcome is measured). Primarily, this is true for treatment methods for one and the same medical condition. However, economists also consider to evaluate medical interventions across heterogeneous medical conditions, in order to rank them with regard to their cost-effectiveness. Using quality-adjusted life-years (QALYs) as outcome variable, all medical interventions examined can be ranked in QALY-League-Tables, which could serve as a basis for resource allocation decisions by health policy makers or other payers. However, there are methodological as well as ethical objections with such an approach.