10.5 The comparator

Most economic evaluations involve a comparator, which should be the intervention most similar to the one being analyzed. The evaluator should not select a comparator with the intention to influence the results (a more costly drug providing similar effects, for example) but should instead choose the comparator based on what is typically offered as a substitute for the intervention under study. In cost-effectiveness and cost-utility analysis, you want to select the most natural comparator, which is the intervention that is the most similar to the one you are analyzing and the most current alternative (Brousselle et al., 2011c; Bryan et al., 2017). If a comparator is needed but does not exist, the status quo can be used as the comparative baseline.