Education and debate

How to read a paper: Papers that tell you what things cost (economic analyses)

^a Unit for Evidence-Based Practice and Policy, Department of Primary Care and Population Sciences, University College London Medical School/Royal Free Hospital School of Medicine, Whittington Hospital, London N19 5NF p.greenhalgh@ucl.ac.uk

	What is economic analysis?

An economic analysis can be defined as an analysis that uses analytical techniques to define choices in resource allocation. This article is based largely on a short booklet by Professor Michael Drummond¹ and two of the forerunners to the "Users' Guides to the Medical Literature" series.^{2 3} A recent book, Elementary Economic Evaluation in Health Care, is also useful.⁴

	Measuring costs and benefits of health interventions

Not long ago, I was taken to hospital to have my appendix removed. From the hospital's point of view, the cost of my care included my board and lodging for five days, a proportion of doctors' and nurses' time, drugs and dressings, and investigations (blood tests and a scan). Other direct costs (see box) included my general practitioner's time for attending me in the middle of the night and the cost of the petrol my husband used when visiting me (not to mention the grapes and . . . [Full text of this article]

Summary points

	Ten questions to ask about an economic analysis

Question 1: Is the analysis based on a study that answers a clearly defined clinical question about an economically important issue?
Question 2: Whose viewpoint are costs and benefits being considered from?
Question 3: Have the interventions being compared been shown to be clinically effective?
Question 4: Are the interventions sensible and workable in the settings where they are likely to be applied?
Question 5: Which method of analysis was used, and was this appropriate?
Question 6: How were costs and benefits measured?
Question 7: Were incremental, rather than absolute, benefits considered?
Question 8: Was the "here and now" given precedence over the distant future?
Question 9: Was a sensitivity analysis performed?
Question 10: Were "bottom line" aggregate scores overused?

	Acknowledgements

	References

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