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"… we in the United States are so averse to the idea of cost effectiveness that when the Patient Centered Outcomes Research Institute, the body specifically set up to do comparative effectiveness research, was founded, the law explicitly prohibited it from funding any cost-effectiveness research at all.
As with any cost-effectiveness analysis, there are several limitations to this study.
Obviously, any cost-effectiveness evidence hinges on the presence of effectiveness evidence in the first place.
Limitations of this study are similar to those of any cost-effectiveness analysis.
15, 21, 27, 31 A number of limitations of any cost-effectiveness study have to be taken into account.
The validity of any cost-effectiveness analysis is only as plausible as the inputs and assumptions made within the model.
Similar(44)
Discussions of using CXRAY as a screening tool was on the technical aspect, but not on costing side as we did not conduct any cost effectiveness analysis or the social willingness to pay for such a strategy in similar settings.
As the population of patients evolves over time and patients with milder disease are treated, it is highly likely that any cost effectiveness analysis would suggest that a minor benefit potentially conferred by plasma exchange would come at too great a cost when compared with IV methylprednisolone.
One important point to note is that the results of any cost effectiveness or cost/benefit assessment in the US will be influenced by the type of payment system, and by the pay relativities between PA and any comparator group (e.g. physician or NP).
The basic point here is that the 1.7% difference between a simple discrete-time approach and the continuous time approach is minor, and such differences will not change fundamentally any ranking in a cost-effectiveness analysis.
Therefore we have presented health outcomes (RVGE cases prevented) and cost results (cost savings) separately, without any attempt to estimate a cost-effectiveness ratio.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com