Intended for healthcare professionals

Education And Debate Economics Notes

Types of economic evaluation

BMJ 1999; 318 doi: (Published 15 May 1999) Cite this as: BMJ 1999;318:1349
  1. Stephen Palmer, research fellowa,
  2. Sarah Byford, research fellowa,
  3. James Raftery, professorb
  1. aCentre for Health Economics, University of York, York YO1 5DD
  2. bHealth Economics Facility, Health Services Management Centre, University of Birmingham, Birmingham B15 2RT
  1. Correspondence to: Mr Palmer

This is the fourth in a series of occasional notes on economics

The pursuit of efficiency in the healthcare sector requires priority to be given to those treatments which provide the greatest benefit per unit of cost. Alternative interventions often have to be compared to determine whether a change in the mix of interventions would increase efficiency. Although economic evaluations approach costs in a common format, they differ in the way they approach benefits. These differences play a critical role in developing criteria for efficiency.1

Cost benefit analysis involves measuring costs and benefits in commensurate terms, usually monetary. Welfare economics shows that under certain conditions any net excess of monetary benefits over costs represents the gain in welfare by society.1 Cost benefit analysis makes it possible to determine, firstly, whether an individual intervention offers an overall net welfare gain and, secondly, how …

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