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Clin Ther. 1999 Jan;21(1):255-67.

Productivity-cost controversies in cost-effectiveness analysis: review and research agenda.

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College of Pharmacy, The Ohio State University, Columbus 43210, USA.


Productivity costs represent true costs to society and should not be ignored in a cost-effectiveness analysis. However, there is dissension among health economists regarding measurement of productivity costs. Certain health economists argue for inclusion of productivity costs in the denominator of the cost-effectiveness ratio, measured in quality-adjusted life-years. Others argue that productivity costs should be included in the numerator of the cost-effectiveness ratio, measured in dollars using the friction-cost method or the human-capital method. This paper reviews the productivity-cost controversies and offers suggestions for future research addressing the debated issues.

[Indexed for MEDLINE]

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