IDEAS home Printed from
   My bibliography  Save this article

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


  • 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.

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

    Download full text from publisher

    File URL:
    File Function: Link to full text; subscription required
    Download Restriction: no

    References listed on IDEAS

    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, June.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. 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.
    2. 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.
    3. 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.

    More about this item


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:17:y:2008:i:3:p:441-448. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing) or (Christopher F. Baum). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.