ECONOMIC APPRAISAL IN THE BRITISH-NATIONAL-HEALTH-SERVICE - IMPLICATIONS OF RECENT DEVELOPMENTS

This paper discusses the role of economic appraisal in the U.K. Nation al Health Service, with particular emphasis on the impact of the recen t reforms. A number of agencies, including the Department of Health, r esearch councils, health authorities and industry, fund appraisals, th e majority of which are carried out by academic researchers. To date t here is little formal documentation of the impact of appraisals. The r ecent reforms should, in principle, increase the opportunities and dem and for economic appraisal. The reforms establish an internal market f or health care with separate roles for purchasers and providers. There are opportunities for using appraisals in deciding whether or not to place a contract, in deciding on the contract specification and in mon itoring the prescribing budgets of general medical practitioners. The new NHS research and development strategy also places particular empha sis on research into the effectiveness and cost-effectiveness of healt h technologies, and on getting the results of research used in decisio n making.