Avoiding research waste through cost-effectiveness analysis: the example of medication adherence-enhancing interventions

Cost-effectiveness analysis (CEA) in health care has two important goals. One is to inform current funding decisions and the other is to inform future research. In the current literature, however, the first goal seems to play a much larger role than the second. The purpose of this note is to show, using the example of medication adherence-enhancing interventions, that CEA can play an important role in informing future clinical trials. In this example incremental cost-effectiveness ratios of drug treatment larger than zero generally prohibit the conduct of clinical trials on the efficacy/effectiveness of adherence-enhancing interventions. Current evidence suggests, however, that CEAs on drug treatment are rarely conducted before running such trials.