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Med Decis Making. 2016 Jan;36(1):132-6. doi: 10.1177/0272989X15583496. Epub 2015 Apr 29.

An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier.

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Department of Management Science and Engineering, Stanford University Stanford, CA, USA (SS)
Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA (JDG-F).


Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem.


cost-effectiveness analysis frontier; net monetary benefit

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