Economic Analysis
Users' Guides to the Medical Literature
Evidence-Based Medicine Working Group

Are the Results Valid?
Did the analysis provide a full economic comparison of healthcare strategies?
Were the costs and outcomes properly measured and valued?
Was appropriate allowance made for uncertainties in the analysis?
Are estimates of costs and outcomes related to the baseline risk in the treatment population?

What Were the Results?
What were the incremental costs and outcomes of each strategy?
Do incremental costs and outcomes differ between subgroups?
How much does allowance for uncertainty change the results?

Will the Results Help Me in My Patient Care?
Are treatment benefits worth the harms and costs?
Could my patients expect similar health outcomes?
Could I expect similar costs?

JAMA 1997; 277:1552-1557

Economics is not just about money; it explores the balance between costs and consequences of alternative actions.

A Full Economic Comparison analyzes both the costs and consequences of 2 or more alternative healthcare strategies. There are 3 types:
1 ) Cost-Benefit Analysis compares the strategies' costs with benefits expressed in monetary units
2) Cost-Effectiveness Analysis compares the strategies' costs with their effects in clinical units (e.g., cost per life years gained)
3) Cost-Utility Analysis is a type of CEA in which outcomes are measured in terms of social value (e.g., cost per QALY).

Direct Health Costs measure actual resources consumed to provide healthcare

Indirect Health Costs measure resource implications of healthcare on other activities (e.g., lost wages)

Discounting permits a comparison of future costs and consequences at today's value

Finding an Economic Analysis

economic analysis ( tw) cost-benefit analysis ( mh)