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    Glenn Salkeld

    In health economics, the companion methodological fight to the disease wars has been the ‘Cost of Illness’ (COI) approach versus ‘Cost Effectiveness’. The disease wars are based firmly in the COI camp. Colleagues, I have to tell you that the methodological war ended years ago. In health, cost of illness was vanquished – sent off to pasture. Instead we saw the rise of cost effectiveness analysis in Australia, the UK and many Western countries as the preferred approach to guiding public health care resource allocation. It is no accident that the PBAC or MSAC did not foramlly adopt cost of illness methods to decide what drugs or MBS items would get funded. COI is unable to answer even the most basic questions of what to fund and how much to fund.

    So why do we pay any attention to these dollar-based disease wars? Could it be that we all respond to a good scare? Has anybody attempted to add up the total cost of each body organ/system covered in the Access Economics disease reports? That’s bound to provide a good scare.

    Let’s stop paying attention to this dollar nonsense. It’s antithetical to good health policy and grossly inequitable.


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