Does MCDA trump CEA?

Editorial published by Carlos Campillo-Artero, Jaume Puig-Junoy, Anthony J. Culyer in APPLIED HEALTH ECONOMICS  HEALTH POLICY

A growing literature of multicriteria decision analysis (MCDA) claims that it is superior to economic evaluation in health technology assessment (HTA). The main arguments are that: 1) MCDA includes a comprehensive and explicit list of value criteria not captured by the traditional methods of economic  evaluation; 2) since it allocates quantitative weights to the different evaluation criteria, their relative importance is incorporated explicitly in the evaluation, thus making values and elicited preferences more consistent and transparent; and 3), the participation of all agents involved in assessing the value of alternatives increases the legitimacy of the process (1-14). Arguments against MCDA include the inadequate treatment of opportunity cost, its vulnerability to double counting, and the fallacious attribution of deficiencies to methods of EA like cost-effectiveness analysis (CEA) in HTA (13-24). We do not consider further the third of the arguments for, because such participation seems to be a standard element of good practice in CEA (25-32).


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