Yoav Golan, MD; John B. Wong, MD; Stephen G. Pauker, MD
Potential Financial Conflicts of Interest: Honoraria: Y. Golan (Cubist Pharmaceuticals, Wyeth, Merck & Co. Inc.); J.B. Wong (Schering-Plough, National Library of Medicine, National Institute of Drug Abuse, Agency for Healthcare Research and Quality); Grants received: J.B. Wong (National Library of Medicine, National Institute of Drug Abuse, Agency for Healthcare Research and Quality, Schering-Plough).
Golan Y, Wong JB, Pauker SG. Survivor Costs in Cost-Effectiveness Analysis. Ann Intern Med. 2006;144:535. doi: 10.7326/0003-4819-144-7-200604040-00021
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Published: Ann Intern Med. 2006;144(7):535.
Dr. Gandjour raises an interesting point: The exclusion of survivor costs (costs associated with a treatment because it extends the patient's life) could affect the calculated cost-effectiveness ratio. He suggests that we calculated unduly favorable cost-effectiveness ratios because we excluded such costs.
The purpose of cost-effectiveness analysis is to provide a metric of comparison of potential uses of limited resources (the “medical commons” ). There is no gold standard for the threshold of willingness to pay. To be useful, such analyses must use standard methods, as we have done (2).
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