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Education And Debate

Economic evaluation in health: a thumb nail sketch

BMJ 1998; 316 doi: (Published 30 May 1998) Cite this as: BMJ 1998;316:1663
  1. D P Kernick (, general practitioner
  1. St Thomas Medical Group, Exeter EX4 1HJ
  1. Correspondence to: Dr Kernick
  • Accepted 2 February 1998

Health economics uses traditional economic theory to consider problems in health care. Although health economics can be applied at a number of levels, including analysis of the demand for health care, planning and budgeting, monitoring and evaluation, it is economic evaluation of treatments that will be of most interest to doctors. Against a background of increasing demands on limited health resources, economic evaluation helps decision making by considering the “outputs” of competing interventions in relation to the resources that they consume (figure). To address these issues, relevant outputs must be defined, costs measured, and studies relating outputs to their costs undertaken.1

Economic evaluation relates outputs of competing interventions to the resources consumed

Doctors will be presented with increasing numbers of economic studies relevant to all aspects of health care. All studies will have the same basic constructs. Here, simple analysis of the title page and summary of a published paper on ramipril in heart failure (reprinted in the box) is used to highlight issues to be borne in mind when assessing ductory texts

  • Jefferson T Demicheli V Mugford M. Elementary economic evaluation in health care. London: BMJ Publishing Group, 1996

  • Drummond M Maynard A. Purchasing and providing cost effective health care. London: Churchill Livingstone, 1993

  • Drummond M Stoddart GL Torrance GW. Methods for the economic evaluations of health care programmes. Oxford: Oxford University Press, 1997

economic evaluations in health. Points at issue are italicised and numbered in relation to subsequent annotations.

Summary points

Economic evaluations utilise economic theory to facilitate choice between competing health interventions when resources are scarce

Guidelines for the conduct of these studies exist, but disagreement over methodology and inherent problems in many areas, such as valuation of human life and wellbeing, remain

A working knowledge of the subject is essential if those delivering health care are …

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