Economic evaluation and health care decision-making.

The current role of economic appraisal in health policy and medical practice is outlined, emphasizing the pharmaceutical sector where developments are most marked. General health policy in the Netherlands and pharmaceutical policy in Australia are presented as examples of how economic appraisal may diffuse further as a decision-support tool for health authorities. This can be promoted by studying how policy-makers interpret and use results of economic evaluation studies and how the international transferability of information on the cost-effectiveness profiles of health technologies can be enhanced. To be relevant for health policy, results from economic appraisal studies must be valid and reliable, relevant to the policy context and communicated to the proper decision-makers. A number of recommendations are provided for economic appraisals to meet such requirements.