Productivity costs in cost-effectiveness analysis: numerator or denominator: a further discussion

In this response we concentrate on what Weinstein et al. call the 'major disagreement' between the Erasmus group and the US Panel, which concerns the measurement of productivity losses during illness. We consider the consequences for the individual, for the employer and for the rest of society and argue that when following the Panel's propositions for measuring these consequences, major theoretical and practical difficulties are encountered. © 1997 John Wiley & Sons, Ltd.