Introduction 1. In recent years considerable efforts have been made to increase the evidence base for decision making within the NHS. Under the NHS R&D Programme a sizeable percentage of NHS resources have been spent on research, one of the largest programmes of research being in the field of...

Integrated care is often perceived as a solution for some of the major challenges faced by health and social care systems. In these systems, 20% of the population accounts for 80% of the expenditure on care [1]. These ‘high users’ are typically people with one or more long-term...

Arguments are being made more frequently to incorporate economic evaluations and quality of life assessments into clinical trials. Using two randomised, multicentre trials of radiotherapy for cancer as an example, this paper outlines: (1) the importance of including such assessments; (2) the...

Approximately 17.5% of all pregnancies in England are induced. Induction of labour may be required for several reasons. These include hypertension, intra-uterine growth retardation, diabetes, poor weight profile of the mother and prolonged pregnancy. The two principle methods used to induce...

Although economic evaluation in health care has a long-standing tradition in the United Kingdom, very little is known about its impact on decision making, particularly following the introduction of the internal market. Since managed competition appears to be growing in popularity worldwide, the...

In this paper we assess the current state of the art of economic appraisal of health technologies in the United Kingdom. The paper is organised along the lines suggested in the Workshop proposal. Although the main interest of the Workshop is in 'high' technology, such as imaging techniques and...

In the summer of 1990, the Australian government took a major step by requiring evidence of cost-effectiveness of new medicines prior to reimbursement by the public health care system. This paper assesses whether the methodological principles behind the guidelines are sound and whether they...

This report examines the effectiveness and cost-effectiveness of screening for diabetic retinopathy by optometrists. There are strong arguments for screening. Diabetic retinopathy is an important public health problem, there is an effective treatment, the natural history of the disease is well...

The objective was to develop an economic prioritisation model to assist those involved in (i) the selection and prioritisation of health technology assessment topics and (ii) commissioning of HTA projects. The model used decision analytic techniques to estimate the expected costs and benefits of...

This paper will concentrate on the use of technology in general practice rather than in primary care as a whole. The following items are discussed in turn: basic medical equipment, minor surgery, diagnostic technology and information technology. The results of a study of the use of fundholding...