Understanding Economic Evaluation: A Policy Perspective for Clinicians

The rhetoric of ‘efficiency’ frames much current debate about how limited health care resources should be used. Clinicians increasingly turn to economic evaluation literature to discern evidence‐based claims of ‘efficiency’ or ‘cost effectiveness’ from empty ones. Economic evaluation research is designed to compare health services on the basis of their efficiency (eg, how well they produce health benefits relative to resource costs). Although economic studies appear throughout the respirology literature, relatively few are complete economic evaluations. Economic evaluation studies serve various purposes, including critical evaluation and persuasive marketing, which produce studies that vary in research agendas and scientific rigour. This paper is intended to serve clinicians and consumers of economic evaluation studies by: introducing economic evaluation research information as a policy making tool; describing the three basic elements and three basic types of economic evaluation (cost‐benefit, cost‐effectiveness, and cost‐utility analyses); and reviewing some limitations of economic evaluation information for policy decision making. The usefulness of economic evaluation research for policy making depends not only on the scientific merit of the analysis but also crucially on whose specific concerns the research questions address.