Cost-effectiveness analysis

Martin Knapp In progress  


Decision-makers in care systems are facing daunting economic realities: needs and aspirations are growing while both public and private resources appear to be shrinking. Very difficult decisions have to be taken about how to use the resources available to those decision-makers so that they can achieve the best possible performance.

In this context, ‘performance’ could mean better access to support for people with care needs, more needs met in a timely fashion or higher wellbeing for people who use services or provide unpaid care. Performance could also mean greater efficiency or value for money in the delivery of support, or it could mean a fairer distribution of access to care, payments made for services used, or outcomes from support received.

Economic evaluation offers one way to help decision-makers with those difficult decisions and in pursuit of (some of) those different performance aspirations. It offers a structured, conceptually sound way to identify, measure, compare and (if necessary) trade-off the costs and outcomes of two or more interventions or courses of action.


This Methods Review describes how economic evaluation can support decision-making in care contexts or systems so as to get the best out of available resources – how to improve strategic decision-making, care practice and ultimately the lives of individuals affected by care needs.