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Economic evaluation to inform health care decision-making: Promise, pitfalls and a proposal for an alternative path

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  • Brousselle, Astrid
  • Lessard, Chantale

Abstract

Health economic evaluation aims at providing information on the efficiency of interventions. Since the 1980s, there have been major developments in the field, especially in terms of methodologies. As the field has expanded and developed, methodologies have become increasingly sophisticated. In parallel, over the past decade, the conduct of economic evaluations has become more and more institutionalized with, among other things, the creation of the National Institute for Health and Clinical Excellence (NICE) in England and Wales and a growing number of health technology assessment (HTA) agencies around the world. Yet the literature has identified important barriers to the use of economic evaluation in decision-making, among them the difficulty of deciphering economic evaluation research. The way the field expanded has thus created a paradox: whereas economic evaluation is seen as an insightful tool for achieving efficiency in health care, its methodological developments have decreased decision-makers' capacity to use it. In this paper, based on a literature survey, we explore this shift by first analyzing how the field of economic evaluation has developed in recent years. Second, we discuss how economic evaluation information is perceived and used in decision-making. Third, we consider a possible direction for reconciling economic evaluation and decision-making. The originality of this article is that it not only highlights the increasing gap between the aim of economic evaluation and its effective use in decision-making but also proposes, based on existing methodologies, a competing approach to the currently dominant paradigm.

Suggested Citation

  • Brousselle, Astrid & Lessard, Chantale, 2011. "Economic evaluation to inform health care decision-making: Promise, pitfalls and a proposal for an alternative path," Social Science & Medicine, Elsevier, vol. 72(6), pages 832-839, March.
  • Handle: RePEc:eee:socmed:v:72:y:2011:i:6:p:832-839
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    References listed on IDEAS

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    Citations

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    Cited by:

    1. Alexei Botchkarev, 2016. "Toward Development of a New Health Economic Evaluation Definition," Papers 1608.01891, arXiv.org.
    2. Walton, Mat, 2014. "Applying complexity theory: A review to inform evaluation design," Evaluation and Program Planning, Elsevier, vol. 45(C), pages 119-126.
    3. Fernando Antoñanzas & Robert Terkola & Maarten Postma, 2016. "The Value of Medicines: A Crucial but Vague Concept," PharmacoEconomics, Springer, vol. 34(12), pages 1227-1239, December.
    4. repec:spr:pharme:v:35:y:2017:i:4:d:10.1007_s40273-016-0477-x is not listed on IDEAS
    5. Elias Asfaw Zegeye & Josue Mbonigaba & Sylvia Blanche Kaye & Thomas Wilkinson, 2017. "Economic Evaluation in Ethiopian Healthcare Sector Decision Making: Perception, Practice and Barriers," Applied Health Economics and Health Policy, Springer, vol. 15(1), pages 33-43, February.
    6. repec:spr:eujhec:v:18:y:2017:i:6:d:10.1007_s10198-016-0823-0 is not listed on IDEAS
    7. Cheung, Kei Long & Evers, Silvia M.A.A. & Hiligsmann, Mickaël & Vokó, Zoltán & Pokhrel, Subhash & Jones, Teresa & Muñoz, Celia & Wolfenstetter, Silke B. & Józwiak-Hagymásy, Judit & de Vries, Hein, 2016. "Understanding the stakeholders’ intention to use economic decision-support tools: A cross-sectional study with the tobacco return on investment tool," Health Policy, Elsevier, vol. 120(1), pages 46-54.
    8. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39.

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