In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe

Susanne Mayer, Michael Berger, Alexander Konnopka, Valentin Brodszky, Silvia M A A Evers, Leona Hakkaart-van Roijen, Mencia R Guitérrez-Colosia, Luis Salvador-Carulla, A-La Park, William Hollingworth, Lidia García-Pérez, Judit Simon*, On Behalf Of The Pecunia Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Improving the efficiency of mental healthcare service delivery by learning from international best-practice examples requires valid data, including robust unit costs, which currently often lack cross-country comparability. The European ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) aimed to harmonize the international unit cost development. This article presents the methodology and set of 36 externally validated, standardized reference unit costs (RUCs) for five health and social care services (general practitioner, dentist, help-line, day-care center, nursing home) in Austria, England, Germany, Hungary, The Netherlands, and Spain based on unambiguous service definitions using the extended DESDE PECUNIA coding framework. The resulting PECUNIA RUCs are largely comparable across countries, with any causes for deviations (e.g., country-specific scope of services) transparently documented. Even under standardized methods, notable limitations due to data-driven divergences in key costing parameters remain. Increased cross-country comparability by adopting a uniform methodology and definitions can advance the quality of evidence-based policy guidance derived from health economic evaluations. The PECUNIA RUCs are available free of charge and aim to significantly improve the quality and feasibility of future economic evaluations and their transferability across mental health systems.

Original languageEnglish
Article number3500
Number of pages15
JournalInternational Journal of Environmental Research and Public Health
Issue number6
Publication statusPublished - 16 Mar 2022


  • TIME
  • economic evaluation
  • health care
  • mental health
  • reference cost
  • service
  • social care
  • societal perspective
  • unit cost
  • valuation


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