Health economists are currently debating, with some suspicion, the relative merits of cost-benefit analysis (CBA), grounded in theoretical welfare economics, and the proliferation of social return on investment (SROI), a pragmatic approach of developing a triple-bottom line (social, environmental and financial), but not grounded in welfare theory. We argue, in rather existential terms, that there is a need to understand the role of heuristics, or prior beliefs, in current ‘best practice’ in CBA and SROI. A taxonomy of CBA and SROI is presented, which summarises the origins of the methods, reporting guidance, publication checklist of quality of reporting, who is wanting these analytical approaches, and policy decision rule present. We argue that a bottom-up SROI is best thought of as localised CBA, building stakeholder involvement right into the framing of SROI, perhaps addressing or mitigating the effects of prior heuristics in top-down CBA. Behavioural CBA and social CBA recognise that people are not rational and that sources of value other than willingness to pay may best reflect social values. Standardisation of SROI and comparison with CBA may illuminate the role of prior heuristics and seek to better reflect social value in weighing up the costs and benefits of public health interventions at both a local and societal level.

健康经济学家目前正在辩论，基于理论福利经济学的成本效益分析（CBA）的相对优点，以及社会投资回报率（SROI）的扩散，这是一种开发三重底线的务实方法（社会、环境和金融），但不以福利理论为基础。我们认为，在相当存在主义的术语中，有必要了解启发式或先前信念在当前 CBA 和 SROI 的“最佳实践”中的作用。提出了 CBA 和 SROI 的分类，总结了方法的起源、报告指南、报告质量的发布清单、谁想要这些分析方法以及存在的政策决策规则。我们认为自下而上的 SROI 最好被认为是本地化的 CBA，在 SROI 的框架中建立利益相关者的参与，也许可以解决或减轻自上而下 CBA 中先前启发式的影响。行为 CBA 和社会 CBA 认识到人们是不理性的，并且除了支付意愿之外的价值来源可能最能反映社会价值。SROI 的标准化和与 CBA 的比较可以阐明先前启发式的作用，并寻求更好地反映社会价值，以在地方和社会层面权衡公共卫生干预措施的成本和收益。