Kosteneffectiviteit van preventie en zorg. Vergelijking preventieve en curatieve interventies
26 May 2012, PDF |
70 pages |
Hamberg-van Reenen HH, Bovendeur I, Feentra TL, van den Berg M
RIVM Report 270091010
A literature review on the comparability of cost-effectiveness analyses of preventive and curative interventions. Cost-effectiveness analyses on preventive and curative interventions as reported in literature are not comparable automatically. It is not possible to do a general pronouncement on what is more cost-effective: prevention or care. Both for prevention and care, favourable and unfavourable cost-effectiveness ratio's have been reported. This can be concluded from an explorative literature review on cost-effectiveness of preventive and curative interventions for stroke and colorectal cancer. This report is the results on a question of the Ministry of Health, Welfare and Sport on the comparability of cost-effectiveness of preventive and curative interventions. Both for stroke and colorectal cancer, large differences have been found at different aspects of cost-effectiveness analyses (i.e. outcome measures, reference, time horizon, discount rate, study design, and presence of uncertainty). Therefore, results from cost-effectiveness analyses cannot automatically be used as input for policy questions regarding prioritizing over diseases or optimal resource allocation over prevention or care. An extra step is needed to make cost-effectiveness ratio's more comparable. This can be done by performing new cost-effectiveness analyses with high demands on consistency, or to interpret, summarize, and analyze the literature in a systematically way, or to do corrections on non-comparable aspects.