This paper describes the development of health services research in The Netherlands in the last decade. For that purpose, an outline of the organisational structure of health research in general is presented first. It is shown that an increasing share of total resources for health research is...

Background: Reimbursement of new drugs is usually based on the budgetary impact of a new drug but there is also increasing demand for cost-effectiveness data on new drugs. Objective: To present a modelling technique (methodology) for an appropriate assessment of the budgetary impact of a new...

This paper asks the question

Objective: To improve the quality of the methods used in Markov modelling studies by increasing the external validity by means of the incorporation of confounding variables. Study design: The concepts were illustrated using a hypothetical Markov model for Parkinson's disease. Methods: The...

The National Institute for Clinical Excellence has recently changed its guidelines on discounting costs and effects in economic evaluations. In common with most other regulatory bodies it now requires that health effects should be discounted at the same rate as costs. We show that the guideline...