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Hospitals, primary care teams, health departments and health purchasing agencies are faced with choices about the best way to use limited resources to achieve their objectives. It was for such purposes that economic evaluation methods evolved. Resources are scarce not just in a country's economy or in our own purse, but also in health systems and, as a consequence, for those who are served by such systems. No matter how rich and powerful a nation becomes, the amount of resources it devotes to health is, and always will be, limited and in competition with other possible uses. Economic evaluation methods are not meant to substitute the decision-making process or be the only tool to be used in such a process, which in any case is a complex cycle. They are only some of the tools available and are useful in clarifying choices and making such choices explicit. They are used to help us make best possible use of available resources in a rational decision-making context, when we want to accrue maximum benefits from our scarce resources.