Technologies with very similar benefits and risks in the same field of diseases are usually compared with methods of health economic evaluations. Either the regional health care system has a system with a more or less explicit willingness to pay framework or the appraisal process has to clarify if an increase in test accuracy (calculated into live years gained –LYG, quality adjusted life years gained – QUALY, incremental cost per LYG or QUALY) is seen as “good value for money”. This willingness to pay consideration may look at
- Burden of disease – the epidemiology as documented in CUR domain
- Severity and prognosis of disease – disease stages detected as shown in EFF domain
- Follow up and treatment as discussed in EFF, SAF, ECO and ORG domain
Usually this considerations are guiding decisions on diagnostic tests in health care and in treatment.