In economic evaluations, which aspect does the perspective determine?

• A. Which costs and benefits are included
• B. Time horizon used
• C. Discount rate applied
• D. Sample size needed

Answer: (A)

The central idea here is that the point of view you adopt in an economic evaluation—the perspective—determines what counts as a cost or a benefit. Different viewpoints include different items in the analysis. For example, a societal perspective includes all costs and benefits, such as direct medical costs, patient time, caregiver time, and even productivity losses. A payer perspective focuses on costs borne by the payer, typically direct medical costs covered by the insurer, and may exclude indirect effects like lost productivity. Because of this, the aspect determined by perspective is precisely which costs and benefits are included in the evaluation.

Time horizon and discount rate are usually set by guidelines, policy questions, or the natural course of the condition, and sample size is driven by study design and statistical power—so they aren’t defined by perspective in the same way.