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Abstract

Cost-effectiveness analysis (CEA) aims to evaluate the additional amount of health that an intervention provides to patients and how much more it costs compared to alternatives. While many health systems have used CEA for decades to inform coverage or reimbursement policies, in the US, it is now a contested political issue. One group of critics contend that CEA may be used to identify patient subgroups who are cost-ineffective to treat, resulting in treatment denials and discrimination. Recently, new perspectives on CEA argue that subgroups should be included to identify opportunities to advance health equity. Given these conflicting claims, this paper considers when subgroup analysis is justifiable and how results should be implemented.

 

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