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JAMA. 2001 Dec 19;286(23):2988-92.

When is it cost-effective to change the behavior of health professionals?

Author information

1
Centre for Health Services Research, University of Newcastle Upon Tyne, Newcastle Upon Tyne, England. james.mason@ncl.ac.uk

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.

PMID:
11743840
[Indexed for MEDLINE]

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