Mason, J; Freemantle, N; Nazareth, I; Eccles, M; Haines, A; Drummond, M; (2001) When is it cost-effective to change the behavior of health professionals? JAMA, 286 (23). pp. 2988-2992. ISSN 0098-7484 DOI: https://doi.org/10.1001/jama.286.23.2988
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Abstract
Because of the workings of health care systems, new, important, and cost-effective treatments sometimes do not become routine care while well-marketed products of equivocal value achieve widespread adoption. Should policymakers attempt to influence clinical behavior and correct for these inefficiencies? Implementation methods achieve a certain level of behavioral change but cost money to enact. These factors can be combined with the cost-effectiveness of treatments to estimate an overall policy cost-effectiveness. In general, policy cost-effectiveness is always less attractive than treatment cost-effectiveness. Consequently trying to improve the uptake of underused cost-effective care or reduce the overuse of new and expensive treatments may not always make economic sense. In this article, we present a method for calculating policy cost-effectiveness and illustrate it with examples from a recent trial, conducted during 1997 and 1998, of educational outreach by community pharmacists to influence physician prescribing in England.
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