HEALTH ECONOMICS EVALUATION

Question 1

what is economic evaluation?

Answer 1

involves assessing the costs and effects of a health intervention compared to alternatives.

Question 2

what is a partial evaluation, outcome description?

Answer 2

a study that looks at one programme and only looks at the outcome

Question 3

what is a partial evaluation, cost description?

Answer 3

a study that looks at one programme and only looks at costs

Question 4

what is a partial evaluation, effectiveness analysis?

Answer 4

a study that looks at 2 programmes comparatively but only looks at the outcomes

Question 5

what is a partial evaluation cost analysis?

Answer 5

a study that looks at 2 programmes comparitively but only looks at the costs

Question 6

what is a partial evaluation cost-outcome description?

Answer 6

a study that looks at one programme but examines both the costs and consequences.

Question 7

what is a full economic evaluation?

Answer 7

a study that looks at two programmes comparatively looking at both inputs and outputs

Question 8

what are some costs looked at in an economic evaluation?

Answer 8

operating costs to healthcare sector
costs to patient and family
costs outside the healthcare sector e.g. social services
costs to wider society e.g. productivity loss whilst in treatment

Question 9

what are some consequences/outcomes looked at in an economic evaluation?

Answer 9

benefits to the patient e.g. QUALY
health service cost savings
savings to families e.g. reduced input of time caring
societal e.g. productivity gain

Question 10

what are the main types of economic evaluation?

Answer 10

cost minimisation analysis
cost effectiveness analysis
cost utility analysis
cost benefit analysis

Question 11

what is cost minimisation analysis?

Answer 11

going for the least costly alternatives when the outcomes of two or more therapies are virtually identical

Question 12

whats the downside of cost minimisation analysis?

Answer 12

it assumes health effects to be equal in each alternative so its only appropriate when prior evidence suggests there is no difference in outcomes between the alternatives which is unusual to see

Question 13

what is cost effectiveness analysis?

Answer 13

It compares an intervention to another intervention (or the status quo) by estimating how much it costs to gain a unit of a health outcome

Question 14

how do you calculate incremental cost effectiveness ratio?

Answer 14

(mean cost of intervention - mean cost of control) divided by (mean effect of intervention - mean effect of control)

Question 15

what are the pros and cons of cost effectiveness analysis?

Answer 15

pros - clinical outcomes are relatively straightforward to measure and to understand
cons - it cannot inform broader resource allocation decisions across different diseases because health benefits will often be measured in different units

Question 16

whats a cost effectiveness plane?

Answer 16

A graphical representation of the incremental costs and outputs of an intervention.
each point represents a patient

Question 17

which quadrant on the cost effectiveness plane requires the most decisions about what to spend on resources?

Answer 17

NE

Question 18

what is a threshold value?

Answer 18

the amount of money willing to spend in order to generate 1 unit of health gain. e.g. 20,000 per quality adjusted life year saved.

Question 19

what is a cost utility analysis?

Answer 19

one type of economic evaluation that can help you compare the costs and effects of alternative interventions. IT measures health effects in terms of both quantity and quality of life. These are combined into a single measure of health: QUALYs

Question 20

what are the pros and cons of cost-utility analysis?

Answer 20

pros - shows benefits in terms of quality and quantity, acilitates comparisons across different health interventions and policies by using a common unit of effect (QALY)
cons - quality of life measures tend to be more subjective than clinical measures, generic health-related quality of life instruments can be less accurate at capturing subtle health effects, for example, effects on mental health, does not capture non-health effects

Question 21

what is a QUALY league table?

Answer 21

a league table which ranks procedures based on marginal cost per QUALY gained. procedures with lowest cost per QUALY recieve highest prioirity.

Question 22

whats the best way to use a QUALY league table?

Answer 22

by purchasing lowest cost/QUALY interventions until the budget is exhausted

Question 23

what are the problems with QUALY league tables?

Answer 23

methods underlying cost per QUALY estimates may differ between studies, may not be equitable as some people need the higher costing treatments, programmes aren’t divisible, insensitive to mental health outcomes so these patients are disadvantaged for healthcare resources

Question 24

what is a cost benefit analysis?

Answer 24

one economic evaluation tool to compare the costs and effects of alternative interventions. CBA measures both costs and effects of interventions in monetary terms

Question 25

what are the pros and cons of cost benefit analysis?

Answer 25

pros - can compare with non-health care interventions, decisions are explicit and transparent because costs and effects are measured in the same units, can inform resource allocation decisions across different healthcare settings

cons - the value assigned to health or non-health benefits in monetary terms may differ according to individuals’ characteristics, such as their socio-economic status, how do we value life/health outcomes/other societal costs

Question 26

whats the preferred economic evaluation tool in the UK?

Answer 26

cost utility analysis using pounds and QUALYs