, Volume 23, Issue 11, pp 1075–1082 | Cite as

Economic evaluations of healthcare programmes and decision making

The influence of economic evaluations on different healthcare decision-making levels
  • Marieke E. van Velden
  • Johan L. SeverensEmail author
  • Annoesjka Novak
Review Article


Given the potential role of economic information in healthcare decision making, it is of interest to assess its influence on decisions at a national or regional level (macro level), at a healthcare facility level (meso level) and at the healthcare provider level (micro level). This literature review summarises 36 empirical studies that examined the influence of economic evaluations on these three healthcare decision-making levels.

Economic evaluations are considered useful and important; however, their direct influence on decision making (instrumental use) is moderate, especially at the macro and micro levels. A major influence was observed at the meso level, leading to the conclusion that economic evaluations have the most pronounced influence on decision making within healthcare organisations. However, unexpectedly, our literature search did not reveal an empirical study analysing the considerable influence of economic evaluations on decisions by the National Institute of Health and Clinical Excellence in the UK.

Our findings indicate that results of economic evaluations cannot be considered the dominant decision criterion for healthcare decision makers at either the macro, meso or micro levels. Enlightenment use (where scientific evidence provides a background of information, ideas and concepts that affect the way policy makers view problems and solutions) of economic evaluations in decision making remains to be proven.


Economic Evaluation Macro Level Healthcare Organisation Healthcare Decision Pharmacoeconomic Evaluation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors received funding from Roche Nederland BV, Woerden, The Netherlands. AN is employed by Roche Nederland BV. No other potential conflicts exist. The views expressed in this paper are those of the authors only and they accept full responsibility for any errors or inaccuracies that may remain.


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Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Marieke E. van Velden
    • 1
  • Johan L. Severens
    • 1
    • 2
    Email author
  • Annoesjka Novak
    • 3
  1. 1.Department of Health Organization Policy and EconomicsUniversity MaastrichtMaastrichtThe Netherlands
  2. 2.Department of Clinical Epidemiology and Medical Technology AssessmentUniversity Hospital MaastrichtMaastrichtThe Netherlands
  3. 3.Roche Nederland BVWoerdenThe Netherlands

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