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This approach could improve the quality of Public Health economic models, supporting efficient allocation of scarce resources.

Although this approach involves a nontrivial investment of time and resource, its value may be realized when 1) multiple options for service change require economic analysis at a single time point, 2) a disease service changes rapidly and the model can be reused, 3) current services within a pathway have not been subjected to economic analysis, 4) upstream events are expected to have important downstream effects, or 5) simple cost-utility decision rules fail to reflect the complexity of the decision-makers' objectives.

Naftidrofuryl oxalate and cilostazol are both effective treatments for claudication; naftidrofuryl oxalate is likely to be the most effective, with minimal serious adverse events.

ObjectivesTo identify the key methodological challenges for public health economic modelling and set an agenda for future research.MethodsAn iterative literature search identified papers describing methodological challenges for developing the structure of public health economic models. Additional multidisciplinary literature searches helped expand upon important ideas raised within the review.ResultsFifteen articles were identified within the formal literature search, highlighting three key challenges: inclusion of non-healthcare costs and outcomes; inclusion of equity; and modelling complex systems and multi-component interventions. Based upon these and multidisciplinary searches about dynamic complexity, the social determinants of health, and models of human behaviour, six areas for future research were specified.ConclusionsFuture research should focus on: the use of systems approaches within health economic modelling; approaches to assist the systematic consideration of the social determinants of health; methods for incorporating models of behaviour and social interactions; consideration of equity; and methodology to help modellers develop valid, credible and transparent public health economic model structures.Electronic supplementary materialThe online version of this article (doi:10.1007/s00038-015-0775-7) contains supplementary material, which is available to authorized users.