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Cost-effective public health guidance: asking questions from the decision-maker's viewpoint

Author

Listed:
  • Kalipso Chalkidou

    (Research and Development, National Institute for Health and Clinical Excellence, London, UK)

  • Anthony Culyer

    (University of York, York, UK)

  • Bhash Naidoo

    (Centre for Public Health Excellence, National Institute for Health and Clinical Excellence, London, UK)

  • Peter Littlejohns

    (National Institute for Health and Clinical Excellence, London, UK)

Abstract

In February 2004, in his assessment of the long-term financial viability of the NHS, Derek Wanless recommended the use of 'a consistent framework, such as the methodology developed by NICE, to evaluate the cost-effectiveness of interventions and initiatives across health care and public health'. One year later public health was added to NICE's remit and the new National Institute for Health and Clinical Excellence (NICE) was established, with amended statutory instruments to permit consideration of broader public sector costs when developing cost-effective guidance for public health. With the principle of 'a consistent framework' put forward by Wanless as the starting point, this paper provides an insight into the most challenging aspects of applying the principles of cost-effectiveness analysis in the public health context from the policymaker's perspective. It reflects on the long-term consequences of taking on responsibility for producing public health guidance on the Institute's overall approach to guidance development and describes the tension between striving for consistency and cross-evaluation comparability while ensuring that the methodological tools used are fit for the purpose of developing public health guidance. Copyright © 2007 John Wiley & Sons, Ltd.

Suggested Citation

  • Kalipso Chalkidou & Anthony Culyer & Bhash Naidoo & Peter Littlejohns, 2008. "Cost-effective public health guidance: asking questions from the decision-maker's viewpoint," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 441-448.
  • Handle: RePEc:wly:hlthec:v:17:y:2008:i:3:p:441-448
    DOI: 10.1002/hec.1277
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    References listed on IDEAS

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    1. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
    2. Anthony J. Culyer (ed.), 1991. "The Economics Of Health," Books, Edward Elgar Publishing, volume 0, number 541.
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    Cited by:

    1. 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.
    2. Katherine Payne, 2009. "Fish and chips all round? Regulation of DNA-based genetic diagnostics," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1233-1236.
    3. Johns, Benjamin & Steinhardt, Laura & Walker, Damian G. & Peters, David H. & Bishai, David, 2013. "Horizontal equity and efficiency at primary health care facilities in rural Afghanistan: A seemingly unrelated regression approach," Social Science & Medicine, Elsevier, vol. 89(C), pages 25-31.

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