Discussion of Paper by Jönsson

Abstract

Jönsson’s paper reviews a series of national studies on the cost of peptic ulcer disease and the impact of cimetidine on those costs. The paper distinguishes three stages in the macroeconomic evaluation of new medical intervention or technology: (1) Estimates of the cost of the target disease; (2) projections of the expected changes anticipated from the introduction of the new technology, called ex ante estimates; and (3) assessment of the actual changes produced by the new technology, termed ex post estimates. The discussion in the paper is organized into three sections which correspond to these divisions — a review of eight national studies of the cost of ulcer disease, ex ante projections of cimetidine’s expected impact on costs in five countries, and ex post measurements in four countries of some of the consequences of cimetidine.