Limits to rationality: economics, economists and priority setting

Area of Science:

• Health Economics
• Health Services Research
• Decision Science

Background:

• Economic evaluation is crucial for healthcare priority setting.
• The practical impact of economic approaches remains limited.
• Understanding barriers to adoption is essential for improving healthcare resource allocation.

Purpose of the Study:

• To investigate the reasons behind the limited impact of economic approaches in healthcare priority setting.
• To identify theoretical and contextual obstacles hindering the adoption of economic evaluations.
• To propose future research directions for health economists.

Main Methods:

• Literature review and theoretical analysis of economic evaluation methods.
• Examination of the broader socio-political and organizational context of healthcare decision-making.
• Synthesis of arguments regarding the limitations of current economic evaluation practices.

Main Results:

• Obstacles stem from theoretical debates on measures like Quality-Adjusted Life Years (QALYs) and data quality issues.
• Non-economic factors, valued by stakeholders (politicians, professionals, public), impede the sole reliance on allocative efficiency.
• Current economic approaches do not fully align with the realities of public sector decision-making.

Conclusions:

• Future impact of economic approaches depends on addressing theoretical and empirical limitations in evaluations.
• Greater consideration of stakeholder values and contextual factors is necessary.
• Health economists must expand research to encompass public sector decision-making, incentives, and constraints.