In modern resource-constrained environments, decision-makers must weigh economic sustainability against real-world impact. Economic cost analysis—distinct from bookkeeping—provides a forward-looking framework for comparing alternatives by measuring both costs and consequences. Three key methods guide these choices. Cost-minimization analysis (CMA) applies when competing options deliver truly equivalent outcomes; the least expensive alternative is preferred. Its use is limited to perfectly interchangeable scenarios, such as bioequivalent generics or identical service contracts. Cost-effectiveness analysis (CEA) compares interventions whose outcomes differ but share a common natural unit—life-years gained, cases prevented, or test scores improved. By calculating an incremental cost-effectiveness ratio (ICER), CEA quantifies the additional cost per unit of benefit, helping prioritize interventions under a willingness-to-pay threshold. Finally, cost-benefit analysis (CBA) places both costs and diverse benefits on a common monetary scale—through benefit-cost ratios or net present value—enabling direct comparison across sectors. Though powerful, CBA requires careful valuation of non-market outcomes, such as lives saved or productivity gains. Selecting among CMA, CEA, and CBA depends on outcome equivalence, measurability, and comparability. Together, these tools equip healthcare managers and policymakers to allocate limited resources transparently and effectively, balancing efficiency with ethical and societal priorities.