Representing uncertainty: the role of cost-effectiveness acceptability curves

Decision‐making in health care is inevitably undertaken in a context of uncertainty concerning the effectiveness and costs of health care interventions and programmes. One method that has been suggested to represent this uncertainty is the cost‐effectiveness acceptability curve. This technique, which directly addresses the decision‐making problem, has advantages over confidence interval estimation for incremental cost‐effectiveness ratios. However, despite these advantages, cost‐effectiveness acceptability curves have yet to be widely adopted within the field of economic evaluation of health care technologies. In this paper we consider the relationship between cost‐effectiveness acceptability curves and decision‐making in health care, suggest the introduction of a new concept more relevant to decision‐making, that of the cost‐effectiveness frontier, and clarify the use of these techniques when considering decisions involving multiple interventions. We hope that as a result we can encourage the greater use of these techniques. Copyright © 2001 John Wiley & Sons, Ltd.