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Health economics has developed on a truly massive scale in the past 20 years. As the pressure on health budgets has grown, so too has the “priesthood” seen by politicians and funding agencies as well equipped to answer key questions about what health care should and should not be provided. In practice, the tools and answers of health economists are severely limited, by methodology, politics, and ethics. But while not answering key questions, economic analysis can shed light on the questions and give those making the decisions a much clearer idea of the choices they face.
Analysis to help choice of treatment, for governments and insurers, usually falls into one of three categories: cost minimisation; cost effectiveness; and cost utility. However, definitions vary in practical use and many authors have now merged some of these categories into cost effectiveness or cost benefit studies.
A cost minimisation study is the simplest, focusing on comparing treatments with an (assumed or demonstrated) identical outcome. For example, an early …
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