If an intervention costs more and yields more health gains, the ICER would fall in which quadrant?

• A. Lower right quadrant (better outcomes and lower cost).
• B. Upper left quadrant (worse outcomes and higher cost).
• C. Lower left quadrant (less costly and less effective).
• D. Upper right quadrant (more costly and more effective)

Answer: (A)

When an intervention costs more and yields more health gains, the key idea is that both the incremental cost and the incremental effect are positive. On the cost-effectiveness plane, this places the result in the quadrant that represents higher cost with better outcomes—the upper-right region. The ICER in this case is the additional cost per additional health gain, and you’d judge its value by comparing it to the willingness-to-pay threshold to decide if it’s worth it. The other quadrants describe different combinations (more effective and cheaper, less effective and more costly, or less effective and cheaper), which do not match paying more for more health.