Understanding the Resistance
This chapter argues that resistance to CEA, in part, reflects American cultural conventions, which lean toward market-based solutions and away from government policies that examine returns on investment in medical interventions from the public's perspective. Another challenge involves the evidence base. Cost-effectiveness data often are unavailable at the time of a technology's diffusion into practice. Existing CEAs may ignore the practical needs of decision makers by excluding implementation costs for programs or the fidelity of implementation in actual practice.
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