Economic evaluation studies in respiratory medicine.

The need for efficient use of resources in the provision of health care is now an accepted reality. Despite its economic significance, respiratory disease has been the subject of very few examples of the application of techniques of economic evaluation. There are a number of examples of cost-minimization studies, and these serve to emphasize that choices based on drug acquisition costs may be quite different from those based on the total costs of care. The difficulty of defining uni-dimensional measures of health outcome for respiratory disease has hampered the development of cost-effectiveness studies, and the future of these must lie with the efforts to develop measures of quality of life more appropriate to this area of medicine. But the multi-dimensional nature of relevant health outcomes suggests that cost-utility approaches are likely to play an important future role, as off attempts to directly establish patients' monetary valuations of the health benefits offered by new respiratory medicines.