Taking account of future technology in cost effectiveness analysis.

Cost effectiveness analysis provides a tool for evaluating allocation of resources by characterising different healthcare interventions in terms of the extra cost per added unit of health benefit (box 1). Such analyses are being used increasingly to set national and international health priorities. The UK’s National Institute for Clinical Excellence, for example, is charged with guiding decisions on use of new and existing technologies in the NHS, based in part on cost effectiveness considerations. 3 In recent years innovation in healthcare technology has occurred at an unprecedented pace for some problems, with new options rapidly supplanting existing interventions. We explore how cost effectiveness analysis could be extended to reflect evolving technologies, and how accounting explicitly for future treatment prospects might affect a typical analysis, using treatment for hepatitis C virus (HCV) infection as an example.