Comparing Cost-Utility Analyses in Cardiovascular Medicine

Cost-utility analysis (CUA) is a special case of cost-effectiveness analysis (CEA). In CUA, time spent in a certain health state is weighed by the relative preference (utility) people have to be in that health state, where 0 equals death, and 1 equals perfect health. If the preference weights are assessed using standard methods, such as the time trade-off technique, standard gamble, or a generic utility assessment tool, then comparisons between cost-utility ratios (CUR) are congruent with welfare economic theory. Results of CUAs are expressed in currency units per quality-adjusted life year (QALY). The appeal of CUA is that results are easily interpreted, allowing simple comparisons among alternative interventions, offering a useful aid in making allocation decisions to maximize the value of limited resources. Given continuing development of valuable and costly new medical technologies, CUA seems poised to become an increasingly useful tool in choosing among competing diagnostic and therapeutic alternatives.