Practice guidelines based on clinical and economic evidence

Indispensable tools in future market oriented health care
  • Frans RuttenEmail author
  • Werner Brouwer
  • Louis Niessen

The impact of economic evidence

The general interest in and availability of information on costs and effects of health care programs has grown exponentially over the past decade. Nevertheless the actual impact of economic evidence seems quite limited overall, and the available information does not seem to be used to its full potential. That holds not only for central policies on the definition of the benefit package of health care systems or the reimbursement of services but also (or perhaps especially) for the practice of local health care. Moreover, this problem seems to affect many countries, although some such as the United Kingdom give a more prominent place to economic considerations in determining health policy.

In a recent publication Neumann [1] discusses why in the United States despite the extensive conducting of economic studies by the research community policy makers have been reluctant to use this information. He considers various reasons including a lack of trust in...


Conflict of interest:

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  1. 1.
    Neumann PJ (2004) Using cost-effectiveness analysis to improve health care; opportunities and barriers. Oxford University Press: New YorkGoogle Scholar
  2. 2.
    Devlin N, Parkin D (2004) Does NICE have a cost-effectiveness threshold and what other factors influence its decisions? A binary choice analysis. Health Econ 13:437–452CrossRefGoogle Scholar
  3. 3.
    Niessen LW, Grijseels EWM, Rutten FFH (2000) The evidence-based approach in health policy and health care delivery. Soc Sci Med 51:859–869Google Scholar
  4. 4.
    Antioch KM, Jenning G, Botti M, Chapman R, Wulfsohn V (2002) Integrating cost-effectiveness evidence into clinical practice guidelines in Australia for acute myocardial infarction. Eur J Health Econ 3:26–39Google Scholar
  5. 5.
    Rosenbaum S, Frankford DM, Moore B, Borzi P (1999) Who should determine when health care is medically necessary? N Engl J Med 340:229–232Google Scholar

Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  1. 1.Institute for Medical Technology AssessmentErasmus MCRotterdamThe Netherlands
  2. 2.RotterdamThe Netherlands

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