Health Economics Flashcards
What is the idea behind Economic evaluation?
Health problems can be measured as…
– # of cases
– # of deaths
– amount of pain/disability
– # of individuals with a risk factor
– amount of money spent on the health problem
– lost income due to the health problem
An EE is ….?
a comparative analysis, of two or more options in terms of their costs and consequence
What is the aim of an EE?
Provide decision makers with information that can help resource allocation
decisions.
Comparison of delta in costs with delta in consequences: incremental
analysis
What stages of economic evaluation?
- Definition of the decision problem (or framing the evaluation)
- Identification, quantification, and valuation of the resources (i.e. costs)
needed - Identification, quantification, and valuation of the health consequences
- Presenting and interpreting the evidence for decision making
What is the perspective (Societal) ?
- Takes into account all the costs and all the outcomes of an
intervention, regardless of who incurs them or who gains from them.
– Unspecific of a single audience.
– Large amount of data (e.g. time off work, reduced productivity, welfare
payments, family support,…
What is the perspective (Public Player)?
– Takes into account the costs borne and the outcomes received by the
health sector
Annual cost?
the cost of the intervention on a yearly basis, including all capital and recurrent cost
Capital cost?
that of capital resources which have useful lives >1 yr e.g. equipment, vehicles ..
Recurrent cost?
the value of resources with lives less than 1 year that have to be purchased at least once a year e.g. petrol
Direct cost?
the cost of intervention design, implementation and continuation (e.g. costs of buildings, labs, cost of transport to health care facilities by the patients)
Indirect cost ?
those incurred by patients and carers to enable delivery/receipt of an intervention. Normally measured using wages and
earnings lost
Intangible cost?
e.g. pain, discomfort, welfare issues, reputation
Marginal cost?
the change in total cost if one additional unit of output is produced
Discounting?
adjusting the costs and outcomes at different times into a common time period, usually the present
discount rate?
the rate which costs, and outcomes are discounted to account for time preference
Willingness to pay?
The monetary value, representing the maximum amount an individual
would be prepared to pay out of his/her income, to gain an improvement in
health.
Or an improvement in other outcomes, e.g. surveillance attribute
Examples of resources and types of cost
Condition specific outcomes?
TO pick up changes in health outcomes specific to a disease
ex: prevented cases of TB after a TB screening programme
Life years saved afetr cancer screening
What potential challenge using specific condition outcomes ?
- Dfficult to compare across diseases unless same outcomes
Generic outcomes?
- They present a standardised description of health
- So it allows comparison across diseases
How can generic outcomes be measured?
- Via short health questionaires, measure patient’s health and wellbeing on several domains (pain, mobility, depression …)
Profiles can be converted into a single utility index - examples?
- EQ-5D
- SF-6D
What is involved in a EQ-5D?
