Societal Perspective on the Cost of Illness

The rising costs of health care during the last decades enhanced the importance of economic evaluations in support of decisions on resource allocation. Questions may be raised as to whether the allocation of resources is optimal when measured against the total health gain that an investment brings. Many health economists have emphasised that the high costs of disease may be a necessary but certainly not a sufficient condition for priority-setting in health care (e.g. Drummond, 1992). Additionally, data on the effectiveness of interventions themselves is needed. In health policy the high cost of diseases may lead to priority being given ta those health care programmes which are already costly. Whereas if past resource allocation decisions have been made in an irrational manner, then subsequent policy decisions perpetuate and amplify the initial mistake (Sheill et al., 1987). From a policy point of view, the equitable distribution of costs and consequences across socio-economic groups is a competing dimension upon which decisions are made. Therefore, apart from information on cost-effectiveness, health policy should also be based on ethical considerations (e.g. equity).