• Sebastian Hinde, Anggie Wiyani, Susan Griffin, and Simon Walker.
• Centre for Health Economics, University of York, York, UK.
• Br. Med. Bull. 2017 Dec 1; 124 (1): 113-120.

BackgroundIn the UK, NICE issues guidance on public health initiatives. Failure to report which sectors of the economy are affected by their implementation precludes the appropriate accounting for the full opportunity costs, and has the potential to result in erroneous decision making and inefficient budgetary planning.Sources Of DataWe reviewed all NICE public health guidances available at the time of research, categorizing the sector on which the cost burden of the public health initiatives fall and the extent to which this burden was estimated.Areas Of AgreementThe majority of guidances were determined to be associated with a cost burden on the NHS (n = 48) and local authorities' public health spend (n = 47).Areas Of ControversyExplicit identification and quantification of cost burden by sector of the economy was reported for only eight guidances.Growing PointsIncreasing numbers of research studies are developing methods to robustly consider the implications of cross sector budget impacts.Areas Timely For Developing ResearchFuture NICE guidance should report disaggregated costs across the sectors where they fall. Further research is needed to conceptualize the opportunity cost of financial burdens falling on non-health budgets before optimal decision making in public health is possible.© The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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