between a specific hazard addressed by a regulation (e.g., air pollution, contaminants in food or water) and health risks may not be well understood by scientists. As a result, both BCA and CEA reports must discuss the uncertainty of the estimates and highlight important impacts that could not be quantified.

Table 1-1 summarizes the key similarities and differences between BCA and CEA based on the overview contained in this chapter. Other differences in the implementation of these approaches are discussed in Chapter 2. The table focuses on what is possible under each approach; in reality, deficiencies in the research base or other factors may limit the ability of a particular analysis to include all of the features noted in the table. The Committee encountered some of these challenges in conducting the three case studies, as discussed later in the report.


This chapter introduced the charge of the Committee, provided an overview of the regulatory development process, identified key features of BCA and CEA, and noted their important differences. This last section outlines the organization of the remainder of the report.

Chapter 2 discusses current practices for the conduct of regulatory economic analyses and reviews the various approaches used by individual federal agencies.

Chapter 3 presents criteria for selecting integrated measures and survey instruments, reviews alternative HALY measures and HRQL survey instruments, and describes different strategies to obtain estimates for regulatory CEA.

Chapter 4 reviews the aspects of risk regulation that policy makers need to consider that are not reflected in the cost-effectiveness ratios, including ethical issues related generally to CEA as well as those related to the population and risk characteristics that are not fully captured in the effectiveness measures.

Chapter 5 concludes the report by presenting the Committee’s recommendations for valuing health benefits in the economic analysis of regulations, including recommendations for additional research and data collection.

The appendixes to this report discuss three case studies of regulatory CEAs that the Committee conducted in collaboration with federal agency staff (Appendix A), include commonly used HRQL survey instruments (Appendix B), and provide the full text of OMB Circular A-4 (Appendix C). A glossary and list of acronyms are also included as Appendix D.

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