The value creation of laboratory medicine: a health economics perspective

Laboratory medicine is frequently managed as a visible cost center, although the information it produces can influence diagnosis, prognosis, treatment, patient flow, and resource allocation throughout the care pathway. This narrative review develops a coherent health-economics account of how laboratory medicine creates value. The central proposition is that value is generated through a causal chain: analytically reliable and timely results; reduce uncertainty; changes clinical decisions; changed decisions affect patient outcomes and healthcare resource use; and the aggregate effects may extend to society and the wider economy. Five connected levels of value are distinguished: analytical, clinical, health-system, societal, and macroeconomic value. Analytical quality is indispensable but insufficient, because a test produces meaningful value only when its information is actionable and embedded in an effective clinical pathway. Health-economic evaluation should therefore compare test-treatment strategies rather than isolated assay prices and should include downstream costs, consequences, uncertainty, and implementation conditions. Diagnostic stewardship is the practical mechanism that converts potential value into realized value by addressing both overuse and underuse and by improving test selection, interpretation, and action. The review concludes that laboratory medicine should be evaluated and governed as an information-generating clinical service and a strategic health-system capability, rather than solely as a production unit or budget line. This narrative review is the outcome of the round table discussion entitled "Health Economics: Transforming Laboratory Data into Value" that took place during the 2025 Euromedlab.