The European Journal of Health Economics

, Volume 20, Issue 8, pp 1281–1282 | Cite as

Sustainability of public finances: inclusion of unrelated medical cost only part of the story

  • Mark P. ConnollyEmail author
  • Nikolaos Kotsopoulos
  • Aomesh Bhatt
  • Maarten J. Postma

We read with interest the paper by van Baal et al. establishing the case for including unrelated healthcare costs in economic evaluations to inform decisions on resource allocation in health [1]. The approach proposed by van Baal and colleagues recognizes the externalities of improving health status and the likelihood of ongoing health costs that can arise in relation to allocating decisions. We broadly agree with the premise proposed by the authors, however, we suggest that if we recognize that treating one medical condition gives rise to future externalities and thus the need for healthcare related transfers, we question why stopping at the inclusion of unrelated healthcare costs to economic evaluations and why not consider a broader analytic perspective that includes a range of public costs and benefits attributed to changes in morbidity or mortality that can be attributable to a new intervention or allocation decision.

The authors highlight that ageing populations will increase...



No funding was received in relation to the work described here. AB served as Member of NICE Technology Appraisal Committee (2012–2018); however, the views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of NICE from his prior engagement.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Global Market Access Solutions SarlSt-PrexSwitzerland
  2. 2.Unit of Pharmacoepidemiology and Pharmacoeconomics, Department of PharmacyUniversity of GroningenGroningenThe Netherlands
  3. 3.Department of EconomicsUniversity of AthensAthensGreece
  4. 4.Reckitt Benckiser Research and DevelopmentSloughUK
  5. 5.Unit of Global Health, Department of Health SciencesUniversity of Groningen, University Medical Center Groningen (UMCG)GroningenThe Netherlands
  6. 6.Department of Economics, Econometrics and FinanceUniversity of Groningen, Faculty of Economics and BusinessGroningenThe Netherlands
  7. 7.Department of Pharmacology and TherapyAirlangga UniversitySurabayaIndonesia

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