TABLE 5.

Calculation methods in economic evaluations

Category	Methods
Cost benefit	Costs and benefits are combined to calculate a costbenefit ratio or a measure of netbenefit (benefits minus costs). Cost benefit analysis provides a monetary comparison of estimated costs and benefits; negative consequences contribute to costs and positive consequences contribute to benefits. Requires that costs and consequences can be expressed in monetary terms.
Cost consequence	Costs and consequences are placed into discrete categories for comparison and are not combined to create a single measure or ratio. Cost consequence analysis provides a way for research users to make their own interpretations about the relative value of different costs and consequences. Does not require that both costs and consequences are expressed in monetary terms.
Cost effectiveness	Costs are measured in monetary terms and compared with consequences measured in natural units. Cost effectiveness analysis provides a way to make a relative comparison, based on the relative differences between costs and the standardized units used to measure consequences. Examples of natural units for health‐related outcomes include clinical endpoints, such as end of viral infection, alleviation of symptoms of depression, or lifeyears gained (additional number of years of life lived as a result of receiving a treatment).
Cost minimisation	Costs are measured in monetary terms; consequences are not compared. Cost minimization analysis provides a way to make a comparison when the alternative courses of action being compared have the same effect/consequence and only differ in costs.
Cost utility	Costs are measured in monetary terms and linked to consequences based on a standard measure of health gain or ‘utility’. Examples of utility measures include: Quality Adjusted Life Years (QALYs) ‐ Measure of change in life expectancy combined with the health‐related quality of those years of life. Disability Adjusted Life Years (DALYs) ‐ Measure of life expectancy combined with “healthy years” lost due to morbidity and/or of a health issue. Costutility analysis provides a way to make a relative comparison that accounts for people's health preferences.
Return on investment	Netbenefit (see “Costbenefit”) is expressed as a proportion of costs. Return on investment analysis provides an estimate of the relative size of costs and net consequences (positive minus negative). Typically, return on investment analyses only consider costs and consequences that can easily be expressed in monetary terms.

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