ABSTRACT
The discussion of problems in the measurement of costs and benefits aims to make people cautious about the interpretation of evidence from economic evaluation studies. Economists usually argue that the appropriate perspective for economic evaluation is societal. They argue that a cost is a cost whoever pays, and similarly benefits should be included regardless of who receives them. If the economic evaluation is alongside a clinical trial, this allows both point estimates and standard deviation of costs to be assessed. The most common format for presenting the outcome of economic evaluation is to show the incremental cost-effectiveness ratios of moves from the status quo (do nothing different option) through better but more expensive options, and ideally from the status quo to lower-cost options. It is often objected that modelling introduces extra uncertainty, but not to look at likely future costs and benefits means that serious bias can undermine the findings of economic evaluation.
