Understanding cost effectiveness in neurology

The USA spends more in healthcare per capita than any other country in the world, but ranks last among high-income industrialized nations in major markers of healthcare effectiveness such as life expectancy, maternal mortality, neonatal mortality, and infant mortality. Unlike other high-income industrialized nations, the USA does not have a national agency that systematically evaluates the cost-effectiveness of health care interventions and negotiates their price accordingly. This manuscript aims to introduce the rationale, terminology, advantages, and limitations of cost-effectiveness analysis. Cost-effectiveness analysis compares health interventions and evaluates their incremental value and their incremental cost compared with already existing healthcare interventions. Cost-effectiveness analysis integrates the best available evidence with patients' preferences to inform clinical decision making. Patients with neurological conditions are facing increasing challenges to access healthcare and prescription drugs. Cost-effectiveness analysis may help improve access to the most effective healthcare interventions and prescription drugs while containing healthcare costs.