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What is PCORI’s official policy on cost-effectiveness analysis?

Our founding legislation prohibits us from doing cost-effectiveness analysis. We don’t consider cost effectiveness to be an outcome of direct importance to patients. Applications will be considered nonresponsive if the proposed research:

  • Conducts a formal cost-effectiveness analysis
  • Directly compares the costs of care between two or more alternative approaches to providing care

Proposals that include studies of these issues may measure and report utilization of any or all health services, but may not employ direct measurements of costs of care. Specifically, our funding announcements state that “proposals that include studies of these issues without utilizing a formal cost-effectiveness analysis or directly measuring and comparing costs of care alternatives will be considered responsive and will be reviewed.” 

PCORI does have an interest, however, in studies that address questions about conditions that lead to high costs to the individual or to society. This is included in our review criterion on impact of the condition on the health of individuals and populations. Thus, PCORI is interested in studies that:

  • Examine the effect of costs on patients, such as patients’ out-of-pocket costs, hardship or lost opportunity, or costs as a determinant of or barrier to access to care.
  • Address cost-related issues, such as the resources needed to replicate or disseminate a successful intervention.
  • Evaluate interventions to reduce health system waste or increase health system efficiency.
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