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Is the acceptability curve a reliable tool in the decision making process in pharmacoeconomics?

Is the acceptability curve a reliable tool in the decision making process in pharmacoeconomics?,Michal Jakubczyk,Bogumil Kaminskiy

Is the acceptability curve a reliable tool in the decision making process in pharmacoeconomics?  
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Abstract In the paper we consider a problem of selecting the optimal therapy from a flnite set of available therapies using the cost-beneflt approach and accounting for uncertainty of expected cost and efiect estimation. We concentrate on acceptability curve as a tool supporting the decision maker. We provide the analysis of its properties in two cases | shown to be qualitatively difierent | of two and of more than two available therapies. We also treat separately the case of symmetric and asymmetric distribution of expected cost and efiect estimates. We show that the choice function derived from acceptability curve possesses many non-intuitive and undesirable properties, e.g. it is not coherent and needs not to be monotonic with willingness-to-pay (even for symmetric distributions) and can generate non-transitive preference relation (for non- symmetric estimates). Keywords: acceptability curve, cost-efiectiveness analysis, net beneflt, willingness to pay, uncertainty JEL classiflcation code: C44, D81, I10
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