Abstract

Health care decision-makers are responsible for making the best use of available health care resources. Economic evaluation is concerned with ensuring that the value of what is gained by an activity outweighs the value of what is sacrificed and hence provides a scientific basis for determining whether a particular health care programme represents an efficient use of health care resources. We show how the application of economic evaluation in the field of health economics has strayed from the scientific basis of the economics approach. We analyse the implications of this divergence from science for health care systems and present an alternative approach aimed at restoring a scientific basis for health care decision-making.