Cost-Effectiveness Analysis

CEA is a tool that has seen increasing use in recent decades as decision makers at all levels of health care provision seek to value alternative interventions (or programs, tests, or treatments). Although CEAs can be complex, and are often described using somewhat arcane terminology, the concept at the core of any CEA is fairly simple: to combine the net cost of a given intervention and its outcomes with its effectiveness, then use the resulting cost-effectiveness ratio to compare that intervention to alternative interventions that are aimed at accomplishing the same goal (be it changes in behavior, increases in good health outcomes, or decreases in bad ones). Cost-effectiveness ratios can be calculated differently depending on whether the given intervention must be chosen instead of the alternatives, or whether it can be combined with some of the alternatives. An example of the former approach is choosing an optimal interval for repeat testing of women diagnosed with Chlamydia trachomatis infection. An example of the latter approach is deciding whether to combine repeat testing for C. trachomatis with a behavioral intervention designed to reduce risk behavior subsequent to receipt of a positive test, in which case the behavioral intervention could be combined with any of the potential repeat testing intervals, or could even be done instead of repeat testing). Because CEA provides explicit quantitative ratios showing the tradeoffs made when