Can the Real Opportunity Cost Stand Up: Displaced Services, the Straw Man Outside the Room

摘要: In current literature, displaced services have been suggested to provide a basis for determining threshold value the effects of new technology as part reimbursement process when budgets are fixed. We critically examine conditions under which would represent an economically meaningful value. first show that if we assume least cost-effective finance technology, then incremental cost-effectiveness ratio (ICER) (d) only coincides with related opportunity cost adopting ICER most service in expansion (n), highly restrictive conditions—namely, complete allocative efficiency existing provision health care interventions. More generally, fixed budget comprises two actions; adoption and financing through displacement effect is net these actions. order be pathway within budget, strategy compared alternative reimbursement: optimal reallocation, gain maximizing financed by loss minimizing contraction. The shadow price \( \beta_{c} = \left( {\frac{1}{n} + \frac{1}{d} - \frac{1}{m}} \right)^{ 1} , \) accounts both imperfect (the service, d < m, contraction) inefficiency (n m) characteristic systems.