This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (118)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Quality of Life  • Alert me on articles by topic

Arch Intern Med. 2003;163:1637-1641.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

AN ARTICLE in the February 2000 issue of JAMA concluded that annual retinal screening for many individuals with type 2 diabetes mellitus may not be warranted on grounds of cost-effectiveness. Vijan et al¹ reported that, compared with biannual screening, annual retinopathy screening for low-risk patients with diabetes costs more than $100 000 for each additional quality-adjusted life year (QALY) gained. The results of a study published in the March 2000 issue of the New England Journal of Medicine concluded that extending hospital stays beyond 4 days for patients with uncomplicated myocardial infarctions was economically unattractive, costing more than $105 000 per QALY gained.² These studies demonstrate that commonly used interventions may not be worthwhile investments of health care resources. By contrast, a study published in the June 2000 issue of the Annals of Internal Medicine concluded that, compared with no treatment, sildenafil (Viagra) is a cost-effective treatment for erectile dysfunction, producing an . . . [Full Text of this Article]

THE ARGUMENT FOR A COST-EFFECTIVENESS THRESHOLD

EVIDENCE THAT THE $50 000 TO $100 000 THRESHOLD IS TOO LOW

THE THRESHOLD ONCE CHOSEN MUST BE DYNAMIC

IMPACT OF THRESHOLD ON LONG-TERM COSTS

HOW SHOULD A COST-EFFECTIVENESS THRESHOLD BE USED?

CONCLUSIONS

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Outside the operating room--economic, regulatory, and legal challenges: A collection of perspectives and panel discussion
ALTMAN et al.
Cleveland Clinic Journal of Medicine 2008;75:S61-S73.
FULL TEXT  

Beyond Utilitarianism: A Method for Analyzing Competing Ethical Principles in a Decision Analysis of Liver Transplantation
Volk et al.
Med Decis Making 2008;28:763-772.
ABSTRACT  

Economic Evaluations of Medical Care Interventions for Cancer Patients: How, Why, and What Does it Mean?
Shih and Halpern
CA Cancer J Clin 2008;58:231-244.
ABSTRACT | FULL TEXT  

Prolonged conservative care versus early surgery in patients with sciatica from lumbar disc herniation: cost utility analysis alongside a randomised controlled trial
Hout et al.
BMJ 2008;336:1351-1354.
ABSTRACT | FULL TEXT  

Pharmacoeconomic Concepts in Antiplatelet Therapy: Understanding Cost-Effectiveness Analyses Using Clopidogrel as an Example
Weintraub
J CARDIOVASC PHARMACOL THER 2008;13:107-119.
ABSTRACT  

Cost-Effectiveness of Treatments for Adolescent Depression: Results From TADS
Domino et al.
Am. J. Psychiatry 2008;165:588-596.
ABSTRACT | FULL TEXT  

A Systematic Review of Cost-Utility Analyses in HIV/AIDS: Implications for Public Policy
Hornberger et al.
Med Decis Making 2007;27:789-821.
ABSTRACT  

Is Proton Beam Therapy Cost Effective in the Treatment of Adenocarcinoma of the Prostate?
Konski et al.
JCO 2007;25:3603-3608.
ABSTRACT | FULL TEXT  

Cost Effectiveness of Adjuvant Interferon in Node-Positive Melanoma
Cormier et al.
JCO 2007;25:2442-2448.
ABSTRACT | FULL TEXT  

A review of the cost-effectiveness of face-to-face behavioural interventions for smoking, physical activity, diet and alcohol
Gordon et al.
Chronic Illness 2007;3:101-129.
ABSTRACT  

The Implications of Using US-Specific EQ-5D Preference Weights for Cost-Effectiveness Evaluation
Noyes et al.
Med Decis Making 2007;27:327-334.
ABSTRACT  

Reassessing How Society Prioritizes The Health Of Young People
Eisenberg and Freed
Health Aff (Millwood) 2007;26:345-354.
ABSTRACT | FULL TEXT  

Visual Screening for Malignant Melanoma: A Cost-effectiveness Analysis
Losina et al.
Arch Dermatol 2007;143:21-28.
ABSTRACT | FULL TEXT  

The Value Of Coronary Heart Disease Care For The Elderly: 1987-2002
Rosen et al.
Health Aff (Millwood) 2007;26:111-123.
ABSTRACT | FULL TEXT  

Cost-Utility Analysis of Short- Versus Long-Course Palliative Radiotherapy in Patients With Non-Small-Cell Lung Cancer
van den Hout et al.
JNCI J Natl Cancer Inst 2006;98:1786-1794.
ABSTRACT | FULL TEXT  

To Screen or Not to Screen: Is That Really the Question?
Branson
ANN INTERN MED 2006;145:857-859.
FULL TEXT  

Cost-effectiveness Analysis of Palivizumab in Premature Infants Without Chronic Lung Disease.
ElHassan et al.
Arch Pediatr Adolesc Med 2006;160:1070-1076.
ABSTRACT | FULL TEXT  

Cost-effectiveness of Thromboprophylaxis With Intermittent Pneumatic Compression at Cesarean Delivery.
Casele and Grobman
Obstet Gynecol 2006;108:535-540.
ABSTRACT | FULL TEXT  

The Cost Effectiveness of Implantable Cardioverter-Defibrillators: Results From the Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II
Zwanziger et al.
J Am Coll Cardiol 2006;47:2310-2318.
ABSTRACT | FULL TEXT  

Cost-effectiveness of Continuous Positive Airway Pressure Therapy for Moderate to Severe Obstructive Sleep Apnea/Hypopnea.
Ayas et al.
Arch Intern Med 2006;166:977-984.
ABSTRACT | FULL TEXT  

Cost-effectiveness of osteoporosis screening and treatment with hormone replacement therapy, raloxifene, or alendronate.
Mobley et al.
Med Decis Making 2006;26:194-206.
ABSTRACT  

Estimated Cost-effectiveness of Growth Hormone Therapy for Idiopathic Short Stature
Lee et al.
Arch Pediatr Adolesc Med 2006;160:263-269.
ABSTRACT | FULL TEXT  

An economic evaluation of Herceptin(R) in adjuvant setting: the Breast Cancer International Research Group 006 trial
Neyt et al.
Ann Oncol 2006;17:381-390.
ABSTRACT | FULL TEXT  

Is Technological Change In Medicine Always Worth It? The Case Of Acute Myocardial Infarction
Skinner et al.
Health Aff (Millwood) 2006;25:w34-w47.
ABSTRACT | FULL TEXT  

Cost-Effectiveness of Hospital Pay-for-Performance Incentives
Nahra et al.
Med Care Res Rev 2006;63:49S-72S.
ABSTRACT  

Willingness to Pay per Quality-Adjusted Life Year in a Study of Knee Osteoarthritis
Byrne et al.
Med Decis Making 2005;25:655-666.
ABSTRACT  

Willingness to Pay for a Quality-Adjusted Life Year: Implications for Societal Health Care Resource Allocation
King et al.
Med Decis Making 2005;25:667-677.
ABSTRACT  

Editorial Comment: How Much Is a Good Night's Sleep Worth?
Williams and Holloway
Stroke 2005;36:1293-1294.
FULL TEXT  

Screening for Obstructive Sleep Apnea in Stroke Patients: A Cost-Effectiveness Analysis
Brown et al.
Stroke 2005;36:1291-1293.
ABSTRACT | FULL TEXT  

Cost-Effectiveness of Alendronate Therapy for Osteopenic Postmenopausal Women
Schousboe et al.
ANN INTERN MED 2005;142:734-741.
ABSTRACT | FULL TEXT  

Is Antibiotic Prophylaxis for Bacterial Endocarditis Cost-Effective?
Agha et al.
Med Decis Making 2005;25:308-320.
ABSTRACT  

Optimal Allocation of Testing Dollars: The Example of HIV Counseling, Testing, and Referral
Walensky et al.
Med Decis Making 2005;25:321-329.
ABSTRACT  

The Cost-Effectiveness of Lifestyle Modification or Metformin in Preventing Type 2 Diabetes in Adults with Impaired Glucose Tolerance
Herman et al.
ANN INTERN MED 2005;142:323-332.
ABSTRACT | FULL TEXT  

Incorporating Recipient Choice in Kidney Transplantation
Su et al.
J. Am. Soc. Nephrol. 2004;15:1656-1663.
ABSTRACT | FULL TEXT  

Costs associated with combination antiretroviral therapy in HIV-infected patients
Yazdanpanah
J Antimicrob Chemother 2004;53:558-561.
ABSTRACT | FULL TEXT  

HER-2 Testing and Trastuzumab Therapy for Metastatic Breast Cancer: A Cost-Effectiveness Analysis
Elkin et al.
JCO 2004;22:854-863.
ABSTRACT | FULL TEXT  

Cost-Utility Analysis of Preoperative Radiotherapy in Patients With Rectal Cancer Undergoing Total Mesorectal Excision: A Study of the Dutch Colorectal Cancer Group
van den Brink et al.
JCO 2004;22:244-253.
ABSTRACT | FULL TEXT  

Editorial Comment--Stroke Cost-Effectiveness Research: Are Acceptability Curves Acceptable?
Holloway and Dick
Stroke 2004;35:203-204.
FULL TEXT