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DOI: https://doi.org/10.25040/medicallaw2015.01.011

Med. pravo., 2015; 1(15): 11-25

UDC: 340.6(492):33:366.54:61

ANDRE DEN EXTER

Jean Monnet Chair EU Health Law, Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands, and Visiting professor International Health law, Lviv National Medical University, Ukraine

Where Law and Economics Meet Each Other: Cost-Effectiveness Analysis in Health Care

In health policy, cost-effectiveness analysis (CEA) can help rationalize coverage decision-making. Although some countries apply economic evaluation methods to new medical interventions (mostly pharmaceuticals), approaches are not standardized. One of the reasons is that CEA is inextricably linked with health care rationing, which may result in denial of a less cost-effective treatment method to an individual patient.

From a legal perspective, denial of treatment for fi nancial reasons challenges basic human rights, including the right to life, human integrity and the right to health care. This paper therefore explores the meaning of cost-effectiveness in the courtroom, its relevance to health policy-making, and the link with EU health legislation.

Key words: cost-effectiveness, health law, prioritizing health care, justiciability.

Reference list

1.      Jean Monnet Chair EU Health Law, Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands, and Visiting professor International Health law, Lviv Medical University, Ukraine. Correspondence denexter@bmg.eur.nl

2.       P.J. Neumann, Using costEffectiveness analysis to improve health care. Opportunities and Barriers. New York OUP, 2005. M. Drummond, A. McGuire, Economic evaluation in health care merging theory with practice. New York. OUP, 2001.

3.       Standardizing effects in QALYs enable to compare interventions effectiveness.

4.       Garber et al, Theoretical Foundations of CostEffectiveness Analysis, (reference made in Neumann note 2) p. 27.

5.       Modified example based on M.R. Gold, et al, Cost effectiveness in health care and medicine (New York OUP 1996) p. 14.

6.       L.B. Russell et al, CostEffectiveness Analysis as a Guide to Resource Allocation in Health. Roles and Limitations in M. Gold (note 3) p. 15.

7.       Article 58(3) Health Insurance Act 2006, available through (last visited 11 December 2013)

8.       Bundesgesetz über die Krankenversicherung, 18 March 1994, as amended (KVG), available through (last visited 10 December 2013)

9.       Articles 234, 237 Health and Social Care Act 2012 www.legislation.gov.uk (last visited 10 December 2013).

10.   NICE website what we do. (last visited 10 January 2014).

11.   Articles 10 and 12 of the Swiss Federal Constitution, available through www.admin.ch, Bundesverfassung (last visited 9 March 2014).

12.   European Network for Health Technology Assessment. Definition of HTA. (last visited 9 December 2013).

13.   EUnetHTA, The HTA Core Model Application for Medical and Surgical Interventions (2.0) www.eunethta.net (last visited 9 December 2013).

14.   A. den Exter, Personalized Medicine and Access to Genetic Technologies, (2010) 33 Rev Der Gen H (Law and the Human Genome Review) p. 49.

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