The Economic Evaluation of Healthcare: The Appliance of Science

Abstract

Although one thinks of health economics as a relatively new area, the first studies in applying economic evaluation to healthcare were in the mid-1960s. Requirements for economic studies for reimbursement purposes are growing internationally, with Ireland joining the ‘band’ this year and Holland in 2003. Although this is a rapidly expanding area, there is still a significant number of issues to address in terms of the use of such economic assessments by local healthcare decision makers. Little appears to be known about this area; this paper, in part, presents a brief literature review. The literature suggests that, among other things, clinicians are suspicious of the cost-containment motive around this agenda and of industry sponsorship, that there is a lack of good effectiveness information available to local decision makers, and that significant barriers remain in place at a local level to the effective use of such information. In England and Wales, the National Institute of Clinical Excellence (NICE) has brought cost-effectiveness to the fore, not just efficacy. It is interesting to note that a significant amount of the research is UK-focused. This paper does not attempt to examine the latest on economic evaluation methodology (it is written by a non-health economist) but attempts to draw out some lessons from this review for supplier industries, particularly the pharmaceutical industry.