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Helminth infections of cattle affect productivity in all classes of stock, and are amongst the most important production-limiting diseases of grazing ruminants. Over the last decade, there has been a shift in focus in the diagnosis of these infections from merely detecting presence/absence of infection towards detecting its impact on production. This has been facilitated by studies observing consistent negative correlations between helminth diagnostic test results and measures of productivity. Veterinarians are increasingly challenged to consider the economic aspects of their work, and the use of these tests should now be integrated in economic evaluation frameworks for improved decision making. In this paper, we review recent insights in the farm-specific economic impact of helminth infections on dairy cattle farms as well as in farmer attitudes and behaviour regarding helminth control. Combining better economic impact assessments of helminth infections together with a deeper understanding of the non-economic factors that drive a farmer's animal health decisions should result in more effective control strategies and increased farmer satisfaction.