Cost Benefit

This method compares two interventions but assigns the clinical benefit a monetary value; for example, a year of life is worth $100,000. The figure is usually based on factors related to the overall economic productivity of an individual. Therefore, a treatment that costs $10,000 to prolong life 1 year might be valued if the person generates $100,000/year of value to society but not valued if the person is not productive. This kind of analysis, although common in the areas of business, insurance adjustment, and economics, is rarely used in clinical studies because of the difficulties in assigning a monetary value to a human life, especially if that value is tied into an individual's socioeconomic status. Additionally, this method would almost certainly have a negative impact on most palliative care interventions because these patients rarely generate income.

We have listed a summary of cost-utility studies in Table 11.4 for comparison. Although many of these studies were performed over a number of years with disparate means of analysis and ranges of utility values factored into their equation, they are more likely to be accurate than no data at all and can form the basis of discussion.

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