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Table 1 Comparison of key features of cost-effectiveness analysis (CEA), benefit–cost analysis (BCA) and multi-criteria decision analysis (MCDA)

From: MCDA from a health economics perspective: opportunities and pitfalls of extending economic evaluation to incorporate broader outcomes

Benefits included Health and direct economic consequences of changes in health (such as healthcare spending and productivity loss) All health and non-health benefits (in practice, only a subset of them may be feasible to include) All health and non-health benefits that are deemed important
Outcome of analysis Ratio between net costs and net health gains Ratio between monetised benefits and monetised costs Multiple outcomes representing desirable objectives. They can in principle be integrated into a single outcome (e.g. by taking a weighted sum)
How the trade-off between health and consumption is expressed Cost-effectiveness threshold, the maximum consumption that is judged to be worth foregoing to improve a unit of health Individual willingness to pay to avoid loss of health Explicit or implicit tariffs between different objectives
Source of values for the trade-off Societal judgment, as expressed through a budget limit, an economic reference case, a committee’s deliberations or other means Individual stated or revealed preferences Values elicited from stakeholders or members of the public