Use and Misuse of the Term “Cost Effective” in Medicine

Abstract

Mounting pressure to stem the rise in national health care\nexpenditures has led to the popularization of the term "cost effective."\nFrequently no explicit data are presented to document savings, and the varied\nuses of the term do not always permit unambiguous identification of a single\nstrategy as the most cost effective. Four criteria for cost effectiveness\noften used in the literature are (1) cost effective equals cost saving, (2)\ncost effective equals effective, (3) cost effective equals cost saving with an\nequal or better health outcome, and (4) cost effective equals having an\nadditional benefit worth the additional cost. The authors argue that the term\nshould be restricted to cases in which criterion (4) applies. Terminological\nmisconceptions are discussed through specific examples, and it is contended\nthat many medical choices are influenced by non-monetary values. (KIE\nabstract)