Economic evaluation of health care and policymaking

The interest in economic evaluation of health care programmes is steadily increasing, but the impact of economic evaluations on decisions concerning the allocation of resources to health care programmes is unclear. In this paper we examine different decision and policy situations where economic evaluation of health care programmes could potentially be used. Economic evaluation as an aid to: the development of treatment guidelines, decisions within health care organizations, introduction of new medical technologies, reimbursement decisions, and pricing decisions are examined. It is concluded that economic evaluation seems to be most useful in the development of treatment guidelines and as an aid to reimbursement decisions. The importance of the incentives to use economic evaluation embodied in the health care system is also stressed. It is argued that it is too early to introduce regulations that require the use of economic evaluation in for instance reimbursement decisions. A more cautious approach may be preferred with economic evaluation used more selectively until the methods and the field have developed further.