Financial restrictions and stronger orientation towards outcomes increasingly demand rational decisions to be made about the use of resources in the health care system. Such decisions are the subject of medical, ethical and economic considerations. Management of the health care system requires medical and economic orientation both at the general level and with regard to the selection of suitable forms of care in hospital and medical practices. In this context, evaluative health economics can be a valuable decision-making aid. In order for the results of health economic evaluation studies to be validly interpreted, a minimum of standard methodology and sufficient transparency is required. To this end, recommendations were developed. They are intended to convey standard approaches, without unnecessarily constraining methodologic progress and scientific freedom. Ongoing refinement of the guidelines and adaptation of the current state of health economic research are desirable.