Evaluating the cost-effectiveness of clinical and public health measures

John D. Graham, Phaedra S. Corso, Jill M. Morris, Maria Segui-Gomez, Milton C. Weinstein

Research output: Contribution to journalArticlepeer-review

142 Scopus citations


Cost-effectiveness analysis, an analytic tool that expresses as a ratio the cost of obtaining an additional unit of health outcome, can help decision makers achieve more health protection for the same or less cost. We characterize the state of the cost-effectiveness analysis literature by reviewing how this technique is applied to various clinical and public health interventions. We describe the results of cost-effectiveness analyses for over 40 interventions to reduce cancer, heart disease, trauma, and infectious disease. The cost-effectiveness ratios for these interventions vary enormously, from interventions that save money to those that cost more than $1 million per year of life gained. The methods used to derive the cost- effectiveness ratios also vary considerably, and we summarize this variation within each health area. Greater uniformity of analytical practice will be necessary if cost-effectiveness analysis is to become a more influential tool in debates about resource allocation.

Original languageEnglish (US)
Pages (from-to)125-152
Number of pages28
JournalAnnual Review of Public Health
StatePublished - 1998
Externally publishedYes


  • Cancer
  • Cost-effectiveness
  • Heart disease
  • Infectious disease
  • Trauma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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