Use and Misuse of the Term “Cost Effective” in Medicine

Mounting pressure to stem the rise in national health care has led to the popularization of the term "cost effective. " no explicit data are presented to document savings, and the varied of the term do not always permit unambiguous identification of a single as the most cost effective. Four criteria for cost effectiveness used in the literature are (1) cost effective equals cost saving, (2) effective equals effective, (3) cost effective equals cost saving with an or better health outcome, and (4) cost effective equals having an benefit worth the additional cost. The authors argue that the term be restricted to cases in which criterion (4) applies. Terminological are discussed through specific examples, and it is contended many medical choices are influenced by non-monetary values. (KIE)