Future costs and the future of cost-effectiveness analysis.

In the past decade, the use of cost-effectiveness (CE) analysis to guide resource allocation in health care has grown in the United Kingdom and in continental Europe. Its use in the United States has been far more limited. The political resistance to explicit consideration of costs in the Medicare’s coverage decision making has all but buried efforts to make coverage decisions based on cost-effectiveness criteria, and explicit use of cost-effectiveness analysis is unusual among private U.S. health insurers. Nevertheless, this technique is attracting greater interest among policymakers and private health plans even in the United States, and its adoption elsewhere confirms that it is now seen as an essential tool to increase the efficiency of health expenditures. If it is really to be used, we should make sure that we get it right, and that its guidance will improve well-being. PMC ID: PMC2574706 (July 2008)