, Volume 37, Issue 4, pp 451–456 | Cite as

The Inclusion of Spillover Effects in Economic Evaluations: Not an Optional Extra

  • Werner B. F. BrouwerEmail author


Increasingly, welfare economic evaluations are used in the context of the allocation of scarce healthcare resources. Many jurisdictions prescribe their use in the context of reimbursement, funding, and/or pricing of new health technologies, especially pharmaceuticals. The fact that the outcomes of such evaluations can influence actual allocation decisions in healthcare underlines the importance of a sound methodology and an appropriate decision-making process. Fortunately, in both areas progress has been made over the past decades. However, there remains room for further improvement, for instance in finding appropriate estimates of monetary values of health, developing broader outcome measures than quality-adjusted life-years (QALYs), finding appropriate equity (principles to estimate) weights for health outcomes, and estimating health opportunity costs.

A topic that receives increasing attention in this context is the inclusion in economic evaluations of so-called...


Compliance with Ethical Standards


No funding was received for this commentary and rebuttal.

Conflict of interest

Werner Brouwer has no conflicts of interest other than a long-standing history of advocating the societal perspective in economic evaluations.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Erasmus School of Health Policy & ManagementErasmus University RotterdamRotterdamThe Netherlands
  2. 2.Erasmus School of EconomicsErasmus University RotterdamRotterdamThe Netherlands
  3. 3.Institute for Medical Technology AssessmentErasmus University RotterdamRotterdamThe Netherlands

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