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Medical Decision Making
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DEALE-ing and Discounting

A Simple Way to Compute the Accrued Costs of Preventive Strategies

Isabelle Durand-Zaleski, MD, PhD

Stéphane Zaleski, PhD

Researchers agree on the importance of discounting costs and of including mortality rates in the cost computations. The authors present a simplified mathematical model that allows both DEALE-ing and discounting and permits easy computations of accrued and incremental costs. The general formula of the accrued discounted cost of treating over time of life expectancy is:

A systematic discussion of the errors involved in the DEALE approximation shows that it will in most cases truly describe the ordering of the costs of various treatments. The DEALE are compared with the costs obtained by using actual mortality statistics. It was found that when two strategies have actual costs CA and CB such as CA greater than CB and C A/CB superior to 1.25, the ordering of CA and CB will always be kept in this simplified model. Key words: DEALE; costs; economics; discounting. (Med Decis Making 1994;14:98-103)

Medical Decision Making, Vol. 14, No. 1, 98-103 (1994)
DOI: 10.1177/0272989X9401400112
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