Equity in the health economic evaluation of public health: An overview

Aim: Starting from the claim that public health interventions should aim to improve health equity, the article examines which methodological approaches of health economic evaluation exist to support the analysis of equity-related outcomes of different interventions. Method: Critical review of the relevant literature. Results: Against the background of the normative foundations of health economic evaluation, three methodological approaches and three practical methods are presented that allow for considering health equity concerns in health economic evaluations. Implications of the different approaches and references to the German context are discussed. Conclusion: The use of the instruments presented offers good potential to improve transparency with respect to distributive effects of different allocation decisions. This appears to be necessary in order to meet demands for health equity improving public health interventions - especially in the context of the German Prevention Act.