Money Talks: Deciphering Cost-Effectiveness Research, 2024 (2024 AMW)

The modern resource-constrained US healthcare system is increasingly considering cost-effectiveness in the determination of payment and funding decisions by payers. This transition has already led to changes in the assessment of healthcare technology in the US and other countries. It represents an increasingly important driver of change in clinical practice. Accordingly, cost-effectiveness analyses are increasingly appearing in the Otolaryngology literature. Identifying and interpreting economic analyses requires the ability to decipher methods, models, and results. Yet medical schools and residency programs rarely offer formalized teaching on this critical topic. In this talk, we will provide a clear and concise overview of the major types of economic analysis followed by a five-step process for interpretation and appraisal: (1) Evaluating the dimensions of the economic study (2) Evaluating the decision model and methods (3) Understanding the assumptions of the model and their limitations (4) Interpreting the results and cost-effectiveness implications (5) Understanding how an economic analysis can account for various sources of inherent uncertainty We will cover concepts such as decision-trees and Markov models, discounting, net-present value, and sensitivity analysis concepts necessary to the interpretation of a cost-effectiveness paper each with examples to demonstrate different ways an economic analysis can be conducted. To ground these topics, we will use real example studies from different subspecialties of otolaryngology. With this primer, the clinician should feel better equipped to understand cost-effectiveness literature published in most otolaryngology journals. New to the 2024 submission, we will also discuss how new cost-effectiveness analysis techniques can measure the equity impact of interventions, balancing health disparities and cost-effectiveness.