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

Listed author(s):
  • 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)

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.

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File URL: http://hdl.handle.net/10.1002/hec.1277
File Function: Link to full text; subscription required
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): 3 ()
Pages: 441-448

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Handle: RePEc:wly:hlthec:v:17:y:2008:i:3:p:441-448
DOI: 10.1002/hec.1277
Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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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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