What does ‘cost of a disease’ really mean? A reflection on the framing of research questions related to animal health from an economic point of view

This paper provides a critical examination of the concept ‘cost of disease’, which is currently one of the dominant endeavours in economics of animal health (EAH). Since the 1960s, many scholars have contributed a lot to the further evolution and development of EAH, leading to
substantial theoretical and methodological improvement, Still, it is our view that many studies suffer from a vague formulation of the research question and a too narrow conceptual view on the societal problem. The dominant economic endeavor in veterinary economics is calculating
the cost of disease. However, several issues can be formulated regarding this concept, such as the lack of consistency with which it is used and applied, which impedes meaningful comparisons and hampers useful reflections. More critically, calculating the cost of a disease
somehow departs from the core questions with which economics is concerned, which is decision making when decisions force people to consume finite resources such as time and money. In its prescriptive form, it tries to inform decision makers on the best possible
decision; in its descriptive form it aims to predict how decision makers will react to changes and uses that information to propose changes. When assessing the cost of a disease, it is often unclear and unspoken which decisions are investigated, amongst others since the cost of
disease already partly includes costs associated with decisions related to prevention and monitoring. As such, research in the veterinary economics profession risks wasting enormous resources without actually contributing to better decision making. This paper reviews past
approaches to the estimation of the cost of a disease and the limited settings in which this concept can aid decision making. We further advocate to move from a disease-centric approach to a decision-centric approach and propose a conceptual framework in which such
veterinary economics analysis may be performed.