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Economic evaluation in health care decision making: evidence from the UK


  • Mike Drummond

    () (Centre for Health Economics, The University of York)

  • Jonathan Cooke
  • Tom Walley


Although economic evaluation in health care has a long-standing tradition in the United Kingdom, very little is known about its impact on decision making, particularly following the introduction of the internal market. Since managed competition appears to be growing in popularity worldwide, the UK is an interesting case study, as the reforms are well underway and there have been a number of efforts to conduct and to disseminate economic evaluations. In this paper the potential for using economic evaluation in health care decision making in the UK is discussed. Then its actual impact is assessed in two ways. First, two case studies are discussed, on heart transplantation and the use of pharmaceuticals in the management of labour in pregnancy. Secondly, new data from a recent survey of potential users of economic evaluations are presented, with the emphasis on exploring the reasons for the impact, or lack of impact, of economic results. It is concluded that the NHS reforms increase the potential for the use of economic evaluation. However, there is a need to increase decision makers’ awareness of economic studies and to help them study methodology and results. Although worries about validity of economic studies is one of the major barriers to their use, other important barriers relate to the multiple objectives being pursued, of which increased efficiency is just one, and the difficulties of freeing resources from existing services in order to divert them to more cost-effective treatments and programmes.

Suggested Citation

  • Mike Drummond & Jonathan Cooke & Tom Walley, 1996. "Economic evaluation in health care decision making: evidence from the UK," Working Papers 148chedp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:148chedp

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    References listed on IDEAS

    1. Douglas Coyle, 1993. "Increasing the impact of economic evaluations on health care decision-making," Working Papers 108chedp, Centre for Health Economics, University of York.
    2. Linda Davies & Mike Drummond, 1993. "The costs of induction of labour by prostaglandin E2 or oxytocin: refining the estimates," Working Papers 109chedp, Centre for Health Economics, University of York.
    3. Ross, Jayne, 1995. "The use of economic evaluation in health care: Australian decision makers' perceptions," Health Policy, Elsevier, vol. 31(2), pages 103-110, February.
    4. Henshall, Christopher & Drummond, Michael, 1994. "Economic appraisal in the British national health service: Implications of recent developments," Social Science & Medicine, Elsevier, vol. 38(12), pages 1615-1623, June.
    5. Davies, Linda & Coyle, Douglas & Drummond, Michael & The EC Network on the Methodology of Economic Appraisal of Health Technology, 1994. "Current status of economic appraisal of health technology in the European community: Report of the network," Social Science & Medicine, Elsevier, vol. 38(12), pages 1601-1607, June.
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    Cited by:

    1. Mike Drummond, 1997. "Disease management: who needs it and why?," Working Papers 152chedp, Centre for Health Economics, University of York.
    2. Duthie, Tessa & Trueman, Paul & Chancellor, Jeremy & Diez, Lara, 1999. "Research into the use of health economics in decision making in the United Kingdom--Phase II: Is health economics `for good or evil'?," Health Policy, Elsevier, vol. 46(2), pages 143-157, January.

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    economic evaluation; decision making;


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