Table 1 Basic concepts of economic evaluation differentiated by outcome measurement
Concept of analysis | Identification/Measurement of Effects | Scope of the analysis |
|---|---|---|
CMA | Effects are regarded as equivalent | Allows only comparison of interventions whose results are considered equivalent |
CEA | Single outcome measured in natural parameters | Allows only the comparison of interventions that target the same natural parameter, inadequate to capture multiple impacts |
CUA | Aggregated parameter/utility measure, mostly QALY | Allows the comparison of interventions that target different e.g. health effects, but inadequate for capturing impacts beyond health (or the scope of the specific utility measure) |
CCA | Multiple endpoints Disaggregated analysis of costs and different effects | Does not provide unique efficiency ratios, allows and requires decision makers to make their own trade-offs between different effects |
CBA | Effects are expressed in monetary units, either a) without subjective elements (by avoided health costs) or b) analysis via monetary valuation e.g. of individual willingness-to-pay for it | a) Allows the comparison of different interventions, but disregard effects that are not covered by monetary measures b) Allows the comparison of different interventions and a wide range of effects by capturing individual preferences, but techniques to capture preferences are dependent on who is being questioned and the monetary valuation of health gains is controversial |