costoefficacia

Costoefficacia is a field of economic evaluation that compares the costs and health outcomes of different interventions to determine which provides the best value for money within a given budget. In healthcare, costoefficacia analyses usually express results as the incremental cost-effectiveness ratio (ICER), defined as the difference in costs between two options divided by the difference in their health effects.

Methods and measures: Costs can include direct medical expenses, direct non-medical costs, and indirect costs such as lost productivity. Health outcomes can be measured in natural units (e.g., life-years gained) or in standardized health measures such as quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). A common approach is the cost-effectiveness analysis (CEA) using ICERs, while cost-utility analysis (CUA) explicitly uses QALYs or DALYs. Decision rules often compare the ICER with a willingness-to-pay threshold to decide whether an intervention is cost-effective. Analyses are conducted from a specified perspective (societal, payer, or provider) and require time horizons, discounting for costs and effects, and sensitivity analyses to address uncertainty.

Applications and limitations: Costoefficacia informs resource allocation and policy decisions, including health technology assessment (HTA) processes. Limitations include data quality and transferability across settings, ethical and equity considerations, variations in thresholds by country, and the potential for differing results under alternative perspectives.

Relationship to other methods: It contrasts with cost-minimization analysis (when outcomes are equivalent), cost-benefit analysis (which monetizes health outcomes), and is a foundation of many CUAs that use QALYs to capture both quantity and quality of life.