Opportunity costs and uncertainty in the economic evaluation of health care interventions

Abstract Considerable methodological research has been conducted on handling uncertainty in cost‐effectiveness analysis. The current literature suggests the concepts of net health benefits and cost‐effectiveness accepta‐bility curves to circumvent the technical shortcomings of cost‐effectiveness ratio statistics. However, these approaches do not provide a solution for the inherent problem that the threshold cost‐effectiveness ratio itself is unknown. The authors suggest analysing uncertainty in cost‐effectiveness analysis by directly addressing the concept of opportunity costs using the decision rule described by Birch and Gafni (1992) and introduce a new graphical framework (the ‘decision making plane’) for communicating with policy makers. Copyright © 2002 John Wiley & Sons, Ltd.