Health Economic Studies on Complementary and Integrative Medicine

Over the last few years health economic data have become increasingly relevant for decision makers faced with the challenge of reconciling the growing demand for healthcare services with the funds available [1, 2]. The UK and Germany may serve as examples to highlight this increasing relevance. The National Institute of Health and Clinical Excellence (NICE) was established in 1999 to inform trusts within the National Health Service of England and Wales. It uses cost-effectiveness analysis to guide the allocation of resources across preventative and curative interventions [3]. In general, if a treatment costs more than GBP 20,000–30,000 per additional quality-adjusted life year (QALY), it is not considered cost-effective [4]. In 2004 the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) was established in Germany to provide information on reimbursement and pricing policies for the statutory health insurance funds. It uses a different approach and evaluates competing technologies within specific therapeutic areas, placing more weight on clinical evidence and the relative efficiency of the competing therapies [3]. This new approach has received some criticism [5], but also some support [3]. The difference is that, whereas NICE is guiding resource allocation across an entire system, IQWiG has responsibility within the bounds of a particular therapeutic area. In this editorial I will focus on the more common approach of cost-effectiveness analysis for resource allocation across an entire system. When deciding on how to allocate limited financial resources in healthcare, the core question is: What do we want to pay for? At first glance this seems obvious, namely a costeffective treatment for a given condition. However, in reality it is often difficult to generalize the results from economic studies, partly due to methodological aspects, but also due to the influence of the underlying study setting (e.g. the healthcare system itself). Types of Economic Evaluations