OBJECTIVE To examine the costs and cost effectiveness of telehealth in addition to standard support and treatment, compared with standard support and treatment. DESIGN Economic evaluation nested in a pragmatic, cluster randomised controlled trial. SETTING Community based telehealth intervention in three local authority areas in England. PARTICIPANTS 3230 people with a long term condition ...

BACKGROUND New anticoagulants may improve health outcomes in patients with atrial fibrillation, but it is unclear whether their use is cost-effective. METHODS AND RESULTS A Markov state transition was created to compare 4 therapies: dabigatran 150 mg BID, apixaban 5 mg BID, rivaroxaban 20 mg QD, and warfarin therapy. The population included those with newly diagnosed atrial fibrillation who w...

Concern with the threshold applied in cost-effectiveness analyses by bodies such as NICE distracts attention from their biased use of the principle. The bias results from the prior requirement that an intervention be effective (usually 'clinically effective') before its cost-effectiveness is considered. The underlying justification for the use of cost-effectiveness as a criterion, whatever the ...

BACKGROUND In many countries, the incremental cost-effectiveness ratio (ICER) is used to assess whether an intervention is worth its costs. At the same time, policy makers often feel uncomfortable with refusing reimbursement of any intervention purely on the basis of the fact that the ICER exceeds a specific threshold value. Reluctance to define a single threshold value for the ICER seems to ha...

In low and middle income countries, health workers are essential for the delivery of health interventions. However, inadequate health-worker performance is a very widespread problem. We present an overview of issues and evidence about the determinants of performance and strategies for improving it. Health-worker practices are complex behaviours that have many potential influences. Reviews of in...

This chapter gives an overview of benefit-cost analysis (BCA) and similar evaluation tools, such as cost-effectiveness analysis and technology-based standards, in the context of public health. We describe these evaluation tools, how they are used, their shortcomings, and how they should be interpreted. As with other powerful tools, they are subject to misuse and misinterpretation, even by profe...