In this article health economic implications of screening are analysed. First, requirements screening programmes should fulfil are derived, and methodical standards of health economic evaluation are outlined. Using the example of newborn hearing screening, it is then examined if empirical studies meet the methodical requirements of health economic evaluation. Some deficits are realised: Health economic studies of newborn hearing screening are not randomised, most studies are even not controlled. Therefore, most studies do not present incremental, but only average cost-effectiveness ratios (i.e. cost per case identified). Furthermore, evidence on long-term outcomes of screening and early interventions is insufficient. In conclusion, there is a need for controlled trials to examine differences in identified cases, but particularly to examine long-term effects.