Socioeconomic evaluation in medicine in Europe. Core economic concepts

In most European countries, healthcare cost-containment programmes have failed to meet their targets on a long term basis. For this reason, decision-makers sought effective and rational strategies to assist in the optimal allocation of available resources. The scholarly discipline of economics provides methods and instruments for investigating the rational use of limited resources. In the context of these efforts, socioeconomic evaluations of healthcare programmes have become increasingly important during the last decade. A socioeconomic evaluation is an analysis of all costs and consequences over a relevant time-period for a particular healthcare intervention. For example, a socioeconomic evaluation of an influenza prevention programme should consider the total costs of preventing influenza (costs of the vaccine, vaccination programme and treatment of adverse events), as well as the benefits of such a programme (costs saved as a result of cases of influenza avoided). In general, socioeconomic evaluations usually compare costs and benefits relative to alternative treatment strategies. The core concepts of socioeconomic analyses are as follows: costs and consequences, discounting, marginal and incremental costs, and externalities (spill-over effects). All these concepts are fixed components of published guidelines and should be considered when conducting a socioeconomic evaluation.