Cost and cost-effectiveness guidelines: which ones to use?

Given the increased awareness of the importance of cost-effectiveness in he alth care, there has been a growth in the number of published economic eval uations in recent years. Partly in response to concerns about deficiencies in the methodology of published studies, there has been a growth of interes t in guidelines for economic evaluation. This paper reviews the various obj ectives of economic analyses, and then summarizes the existing groups of gu idelines for cost and cost-effectiveness analyses. Finally, it compares and discusses the appropriate uses and limitations of the guidelines, with par ticular emphasis on those developed for applications in developing countrie s.