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

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