Making the rules make sense: valuation of constrained resources

Excerpt

It was with great interest that I read Professor Lindgren’s editorial [1] on decision making under absolute resource constraints, but I found that it stopped short of one important implication: if there is a shortage of midwives and a new intervention employs a midwife, then the opportunity cost of employing her might not be best reflected by the associated monetary cost but rather the health that she would or could have produced by devoting her time to some other healthcare activities. In this comment, I explain how appropriate consideration of opportunity cost seems to dispel Professor Lindgren’s concerns about the decision rules of cost-effectiveness analysis (CEA). …