The National Institute for Health and Clinical Excellence (NICE) has issued a report (Wonderling D, et al. Ann Intern Med. 2011;154:758-765) explaining the process and value of cost-effectiveness assessments and how these inform recommendations and decisions regarding clinical questions made by the UK National Clinical Guidelines Centre. The report dispels the following 3 myths regarding cost-effectiveness evaluations that further clarify the concept of value in medicine:
Myth 1: The aim of health economics is to save money. This is not the case, says NICE. Rather, the purpose of health economics is to promote as much clinical value as possible for patients, based on available resources.
Myth 2: Expensive interventions are not cost-effective. This is not necessarily the case. The cost of an expensive intervention may be fully or partly offset by its ability to reduce side effects and their associated costs. In addition, an expensive intervention that offers significant health gains may often justify its high cost.
Myth 3: The main goal of cost-effective analyses is to support the implementation of clinical practice. Instead, says NICE, the main goal of such analyses is to determine which interventions are most cost-effective. This can mean that a clinically beneficial intervention may not be recommended if its benefit is not sufficient to justify its cost.
NICE suggests that these misconceptions can explain the reluctance of providers to consider cost-effective analyses as not relevant to the clinical decision-making. Dispelling these misconceptions is therefore key to grasping the true value and implications of this type of research methodology for clinical practice.
