Societal Perspective on Tile Cost of Illness

The rising casts of health care during the last decades ellhallced the importance of economie evaluations in support of decisions on resourc~ allocation. Questions may be raised as to whether the alloeation of resources is optimal when measured against the total health gain that an investment blings. Many health economists have emphasised that the high costs of disease may be a necessalY but cel1ainly not a sufficient condition for priotity-setting in health care (e.g. Dnllllmond, 1992). Additionally, data on the effectiveness of interventions themselves is needed, In health policy the high cost of diseases may lead te priority being given ta those health care programmes which are already costly. \\Vhereas ifpast resource allocation decisions have been made in an inational marmer, then sllbsequent poliey decisions perpehmte and amplifY the initial mistake (Sheill et al., 1987). From a poliey point of view, the eqllitable distribution of costs and consequences across socio-economie groups is a competing dimension upon which decisiolls are made. Therefore. apart from infonllation on cost-effectiveness, health poliey should also be based on ethical considerations (e.g. equity).