What is cost-minimisation analysis?

Authors: Alan Haycox and Antony Martin

Achieving ‘value for money’ implies either a desire to achieve a predetermined objective at least cost or a desire to maximise the benefit to the population of patients served from a limited amount of resources. Cost-minimisation analysis (CMA) relates to the first of these objectives.

Assumptions of clinical equivalence in CMA should only be made if claims of equivalence can be supported by clinical evidence; that is, where measured outcomes have been shown to be equivalent; where this is not possible, a CMA should not be conducted.

What are the main arguments deployed against the use of this technique of economic evaluation?

What steps can be taken to improve the quality and appropriateness of CMAs and in what circumstances is it appropriate to use CMA as a methodology in the economic evaluation of healthcare technologies?

To what extent should healthcare professionals rely on CMAs to inform their decision-making?

How do we measure ‘clinical equivalence’ and what are the implications of potential sources of misinterpretation of clinical data within the framework of CMA?

How can we enhance the reputation and value of CMA as a method of health economic analysis to inform healthcare decision-making?

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