Commentary on "Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science"

The current paper is a commentary on the Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science (Crowley et al. 2018). Although the standards got a lot right, some important issues were not addressed or could be explored further. Measuring rather than modeling is encouraged whenever possible. That also is in keeping with the approach taken by many prevention researchers. Pre-program planning for collection of data on resources used by individual participants (i.e., costs) is recommended, along with devotion of evaluation resources to cost assessment throughout program implementation. A "cost study" should never be an afterthought tacked on as a later aim in a research proposal. Needing inclusion or enhancement in the standards, however, are several key concepts, starting with the often-confused distinction between costs and outcomes. The importance of collecting data on individual-level variability in resource use, i.e., costs, needs to be distinguished from simplistic disaggregation-by-division of program cost totals down to individuals. In some passages of the standards, the uniqueness of individual participants seems dismissed as error variance rather than considered a primary phenomenon for study and understanding. Standards for formatting reports of economic evaluations could themselves be more evidence-based. Missing too is an explicit call for inclusion of the standards' recommendations in peer review of prevention research proposals, and in funding of prevention research. Finally, we can be confident that the better outcomes the standards promise will come at additional costs to prevention researchers. This commentary concludes by considering whether the standards themselves are cost-beneficial.