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Making economic evaluations respectable

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  • Reinhardt, Uwe E.

Abstract

Policy-makers worldwide are on a quest to control national spending for health care and to enhance the value received for whatever is being spent on health care. One should think that the economic evaluation of clinical practice would play a major role in this quest. Alas, so far it has not, in spite of considerable progress in the development of suitable methodology for such evaluations. The central point of this paper is that the sheer conceptual and practical complexities of economic evaluations in this context are not the only and possibly not the major barrier to a more widespread use of this type of analysis. Just as important may be the suspicion among lay persons that such analyses are easily driven by the assumptions the analyst packages into the analysis which, in turn, opens economic evaluation to hidden bias toward favored results. It is proposed in this paper that this particular barrier to the use of economic evaluations in health policy could be overcome if these analyses were more routinely subjected to the rigorous and penetrating audits that are customary in financial accounting. Typically, research papers in economics are audited through peer review only as to the methodology employed. The suggestions here is that a proper, respectable audit ought to penetrate all the way to the data that were used to produce the findings in a study. The paper concludes with some suggestions on how to develop such an audit infrastructure.

Suggested Citation

  • Reinhardt, Uwe E., 1997. "Making economic evaluations respectable," Social Science & Medicine, Elsevier, vol. 45(4), pages 555-562, August.
  • Handle: RePEc:eee:socmed:v:45:y:1997:i:4:p:555-562
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    Cited by:

    1. Stephen Birch & Amiram Gafni, 2002. "On being NICE in the UK: guidelines for technology appraisal for the NHS in England and Wales," Health Economics, John Wiley & Sons, Ltd., vol. 11(3), pages 185-191, April.
    2. Maynard, Alan & McDaid, David, 2003. "Evaluating health interventions: exploiting the potential," Health Policy, Elsevier, vol. 63(2), pages 215-226, February.
    3. Lessard, Chantale, 2007. "Complexity and reflexivity: Two important issues for economic evaluation in health care," Social Science & Medicine, Elsevier, vol. 64(8), pages 1754-1765, April.
    4. Clive Pritchard, 1998. "Trends in Economic Evaluation," Briefing 000444, Office of Health Economics.
    5. Steve Morgan & Morris Barer & Robert Evans, 2000. "Health economists meet the fourth tempter: drug dependency and scientific discourse," Health Economics, John Wiley & Sons, Ltd., vol. 9(8), pages 659-667, December.
    6. Ferrán Catalá-López & Adolfo Alonso-Arroyo & Rafael Aleixandre-Benavent & Manuel Ridao & Máxima Bolaños & Anna García-Altés & Gabriel Sanfélix-Gimeno & Salvador Peiró, 2012. "Coauthorship and Institutional Collaborations on Cost-Effectiveness Analyses: A Systematic Network Analysis," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-9, May.

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