Table 9 Is a formal economic model likely to help? Case example: The licensing of tobacco retailers

The expert report commissioned by the government concerned included an economic analysis. This concluded that the cost per life year saved by licensing tobacco retailers and conducting compliance checks was between approximately €900 and €92 000 with a best estimate of €8 000. The authors noted that there was substantial uncertainty about their estimates and suggested focusing on the range of estimates rather than the best estimate. Nevertheless they reported exact estimates (based on the assumptions they made) and concluded that the empirical basis for recommending licensing tobacco retailers was robust. As a result policymakers who failed to read this report critically could conclude (wrongly in our opinion) that the report provided high-quality evidence that the licensing of tobacco retailers was as cost-effective as (or more cost-effective than) a wide range of clinical preventive services paid for by the government. A more systematic review of the underlying evidence [24] and a summary of the findings that included more systematic and transparent judgements of the quality of the evidence (as shown in Table 1) would have provided a better basis for decision making.