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The European Union (EU) Environmental Impact Assessment (EIA) Directive which was introduced some 25 years ago has had a major impact on decision-making practices in EU member states. In the professional literature, this impact has mostly been discussed under the heading of "effectiveness", with an emphasis being given in particular to procedural elements. The extent to which EIA has contributed to objectives, such as raising environmental awareness and leading to an incorporation of environmental values in decision-making has only been rarely investigated. This paper reflects on these latter two aspects of EIA effectiveness in two EU member states; the Netherlands and the United Kingdom. Empirical evidence was compiled mainly on the basis of a comprehensive literature review and online surveys with EIA professionals in both countries. Our results indicate that overall the instrument is about equally effective in both countries with regards to the incorporation of environmental concerns in decision-making. As both countries have different governance mechanisms, further research is needed on why perceived effectiveness does not differ more.

This paper is a "statement" for the March special issue of JEAPM on "Impact Assessment Research: Achievements, Gaps and Future Directions".

The European Union (EU) Environmental Impact Assessment (EIA) Directive which was introduced some 25 years ago has had a major impact on decision-making practices in EU member states. In the professional literature, this impact has mostly been discussed under the heading of “effectiveness”, with an emphasis being given in particular to procedural elements. The extent to which EIA has contributed to objectives, such as raising environmental awareness and leading to an incorporation of environmental values in decisionmaking has only been rarely investigated. This paper reflects on these latter two aspects of EIA effectiveness in two EU member states: the Netherlands and the United Kingdom. Empirical evidence was compiled mainly on the basis of a comprehensive literature review and online surveys with EIA professionals in both countries. Our results indicate that overall the instrument is about equally effective in both countries with regards to the incorporation of environmental concerns in decision-making. As both countries have different governance mechanisms, further research is needed on why perceived effectiveness does not differ more.

There is a recent expansion in the development and application of genomic technologies, often called “personalized medicine” (PM). This growth in technological capability requires consideration of the potential impact on constrained health care budgets before it moves into clinical practice. There is a need for robust evaluative frameworks to provide decision-makers allocating scarce health care resources with robust evidence of the relative costs and benefits of applications of genomic-based medicine. This chapter: summarizes the existing economic evaluation literature on genomic-based medicine; describes how economic evaluation of genomic-based medicine has emerged into practice using case studies of three countries; and describes challenges in defining and measuring the value of genomic-based medicine and synthesizing costs and benefits for use in economic evaluations. The chapter concludes by looking at the (near) future and describes some key challenges associated with evaluating the economic impact of introducing new ‘sequencing’ technologies into clinical practice. Health economists have two key challenges in the context of genomics and PM. The first is to continue to apply robust methods of economic evaluation. The second is to tackle the methodological and practical issues to generate a sufficient evidence base to inform resource allocation decisions.