UPDATE OF THE DUTCH MANUAL FOR COSTING IN ECONOMIC EVALUATIONS

2012 ◽  
Vol 28 (2) ◽  
pp. 152-158 ◽  
Author(s):  
Siok Swan Tan ◽  
Clazien A. M. Bouwmans ◽  
Frans F. H. Rutten ◽  
Leona Hakkaart-van Roijen
Keyword(s):  
Health Economic ◽  
Action Plan ◽  
Mental Healthcare ◽  
Alternative Methods ◽  
Healthcare Sector ◽  
Economic Evaluations ◽  
International Studies ◽  
National Guidelines ◽  
Reference Prices ◽  
Life Years

Objectives: In 2000, the first “Dutch Manual for Costing: Methods and Reference Prices for Economic Evaluations in Healthcare” was published, followed by an updated version in 2004. The purpose of the Manual is to facilitate the implementation and assessment of costing studies in economic evaluations. New developments necessitated the publication of a thoroughly updated version of the Manual in 2010. The present study aims to describe the main changes of the 2010 Manual compared with earlier editions of the Manual.Methods: New and updated topics of the Manual were identified. The recommendations of the Manual were compared with the health economic guidelines of other countries, eliciting strengths and limitations of alternative methods.Results: New topics in the Manual concern medical costs in life-years gained, the database of the Diagnosis Treatment Combination (DBC) casemix System, reference prices for the mental healthcare sector and the costs borne by informal care-givers. Updated topics relate to the friction cost method, discounting future effects and options for transferring cost results from international studies to the Dutch situation.Conclusions: The Action Plan is quite similar to many health economic guidelines in healthcare. However, the recommendations on particular aspects may differ between national guidelines in some respects. Although the Manual may serve as an example to countries intending to develop a manual of this kind, it should always be kept in mind that preferred methods predominantly depend on a country's specific context.

scholarly journals Experiences of including costs of added life years in health economic evaluations in Sweden

2014 ◽  
Vol 15 (2) ◽  
pp. 45-53 ◽  
Author(s):  
Laura Pirhonen ◽  
Thomas Davidson
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Strong Support ◽  
Point Of View ◽  
Economic Evaluations ◽  
National Guidelines ◽  
Ethical Concerns ◽  
Production And Consumption ◽  
Life Years ◽  
Empirical Point

It is of importance to include the appropriate costs and outcomes when evaluating a health intervention. Sweden is the only country where the national guidelines of decisions on reimbursement explicitly state that costs of added life years should be accounted for when presenting health economic evaluations. The aim of this article is to, from a theoretical and empirical point of view, critically analyze the Swedish recommendations used by the Dental and Pharmaceutical Benefits Agency (TLV), when it comes to the use of costs of added life years in economic evaluations of health care. The aim is furthermore to analyze the numbers used in Sweden and discuss their impact on the incremental cost‑effectiveness ratios of assessed technologies. If following a societal perspective, based on welfare economics, there is strong support for the inclusion of costs of added life years in health economic evaluations. These costs have a large impact on the results. However this fact may be in conflict with ethical concerns of allocation of health care resources, such as favoring the younger part of the population over the older. It is important that the estimates of production and consumption reflect the true societal values, which is not the case with the values used in Sweden.

scholarly journals Why Early Prevention of Childhood Obesity Is More Than a Medical Concern: A Health Economic Approach

2017 ◽  
Vol 70 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Diana Sonntag
Keyword(s):  
Health Economic ◽  
Childhood Obesity ◽  
Overweight And Obesity ◽  
Health Concern ◽  
Economic Evaluations ◽  
International Studies ◽  
Design Phase ◽  
Excess Costs ◽  
Efficient Data ◽  
Obesity Prevention Programs

Background: Childhood overweight and obesity are a non-deniable health concern with increasing economic attention. Summary: International studies provide robust evidence about substantial lifetime excess costs due to childhood obesity, thereby underscoring the urgent need to implement potent obesity prevention programs in early childhood. Fortunately, this is happening more and more, as evidenced by the increase in well-conducted interventions. Nevertheless, an important piece of the puzzle is often missing, that is, health economic evaluations. There are 3 main reasons for this: an insufficient number of economic approaches which consider the complexity of childhood obesity, a lack of (significant) long-term effect sizes of an intervention, and inadequate planning of health economic evaluations in the design phase of an intervention. Key Messages: It is advisable to involve health economists during the design phase of an intervention. Equally necessary is the development of a tailored toolbox for efficient data acquisition.

Quality of health economic evaluations submitted to the Italian Medicines Agency: current state and future actions

2020 ◽  
Vol 36 (6) ◽  
pp. 560-568
Author(s):  
Angelica Carletto ◽  
Matteo Zanuzzi ◽  
Annalisa Sammarco ◽  
Pierluigi Russo
Keyword(s):  
Health Economic ◽  
Good Practice ◽  
Assessment Process ◽  
Sensitivity Analyses ◽  
Economic Evaluations ◽  
Relevant Alternatives ◽  
Current State ◽  
Decision Analytic Modelling ◽  
Life Years

ObjectivesThe purpose of this study was to evaluate the current state of health economic evaluations (HEEs) submitted by pharmaceutical companies to the Italian Medicines Agency (AIFA) as part of their pricing and reimbursement (P&R) dossiers, and to explore potential future actions in order to enhance their quality.MethodsAll company dossiers submitted from October 2016 to December 2018 were reviewed to select those containing pharmacoeconomic studies. The general characteristics of HEEs were described and their quality assessed based on a checklist adapted from Philips et al. (Review of guidelines for good practice in decision-analytic modelling in health technology assessment. Health Technol Assess. 2004;8: 1–158).ResultsOf the 299 dossiers submitted to AIFA, 105 included one or more pharmacoeconomic studies, of which fifty-three were cost-effectiveness analyses. Overall, the compliance of the HEEs with the quality checklist was highly variable: some studies reached high methodological standards whereas others had serious flaws (mean 59.22 percent, range 19.35–90.32 percent). The main weaknesses were the unjustified exclusion of relevant alternatives, poor description and justification of model data and assumptions, and insufficient exploration of uncertainty and study validity. Non-homogeneity across studies was found in study perspectives, discount rates, methods for costing, estimating quality-adjusted life-years and conducting sensitivity analyses.ConclusionsBased on the results of this study, the recommended actions for increasing the quality of HEEs within reimbursement submissions in Italy are twofold: first, to set methodological standards for conducting and reporting HEEs; second, to strengthen the internal assessment process, also through the acquisition of companies' models and re-evaluation of results. These actions will hopefully provide greater contribution to the evidence-based P&R decision making.

scholarly journals INCORPORATING ENVIRONMENTAL OUTCOMES INTO A HEALTH ECONOMIC MODEL

2016 ◽  
Vol 32 (6) ◽  
pp. 400-406 ◽  
Author(s):  
Kevin Marsh ◽  
Michael Ganz ◽  
Emil Nørtoft ◽  
Niels Lund ◽  
Joshua Graff-Zivin
Keyword(s):  
Health Economic ◽  
Environmental Impact ◽  
Economic Model ◽  
Economic Evaluations ◽  
Combination Regimen ◽  
Simple Method ◽  
Life Years ◽  
Health Economic Model ◽  
Economic Analyses ◽  
The Impact

Objectives: Traditional economic evaluations for most health technology assessments (HTAs) have previously not included environmental outcomes. With the growing interest in reducing the environmental impact of human activities, the need to consider how to include environmental outcomes into HTAs has increased. We present a simple method of doing so.Methods: We adapted an existing clinical-economic model to include environmental outcomes (carbon dioxide [CO2] emissions) to predict the consequences of adding insulin to an oral antidiabetic (OAD) regimen for patients with type 2 diabetes mellitus (T2DM) over 30 years, from the United Kingdom payer perspective. Epidemiological, efficacy, healthcare costs, utility, and carbon emissions data were derived from published literature. A scenario analysis was performed to explore the impact of parameter uncertainty.Results: The addition of insulin to an OAD regimen increases costs by 2,668 British pounds per patient and is associated with 0.36 additional quality-adjusted life-years per patient. The insulin-OAD combination regimen generates more treatment and disease management-related CO2 emissions per patient (1,686 kg) than the OAD-only regimen (310 kg), but generates fewer emissions associated with treating complications (3,019 kg versus 3,337 kg). Overall, adding insulin to OAD therapy generates an extra 1,057 kg of CO2 emissions per patient over 30 years.Conclusions: The model offers a simple approach for incorporating environmental outcomes into health economic analyses, to support a decision-maker's objective of reducing the environmental impact of health care. Further work is required to improve the accuracy of the approach; in particular, the generation of resource-specific environmental impacts.

scholarly journals PRIORITIES FOR HEALTH ECONOMIC METHODOLOGICAL RESEARCH: RESULTS OF AN EXPERT CONSULTATION

2017 ◽  
Vol 33 (6) ◽  
pp. 609-619 ◽  
Author(s):  
David Tordrup ◽  
Christos Chouaid ◽  
Pim Cuijpers ◽  
William Dab ◽  
Johanna Maria van Dongen ◽  
...  
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
Health Economics ◽  
Research Agenda ◽  
Health Economic Evaluation ◽  
Complex Interventions ◽  
Economic Modeling ◽  
Economic Evaluations ◽  
Methodological Research ◽  
Life Years

Background: The importance of economic evaluation in decision making is growing with increasing budgetary pressures on health systems. Diverse economic evidence is available for a range of interventions across national contexts within Europe, but little attention has been given to identifying evidence gaps that, if filled, could contribute to more efficient allocation of resources. One objective of the Research Agenda for Health Economic Evaluation project is to determine the most important methodological evidence gaps for the ten highest burden conditions in the European Union (EU), and to suggest ways of filling these gaps.Methods: The highest burden conditions in the EU by Disability Adjusted Life Years were determined using the Global Burden of Disease study. Clinical interventions were identified for each condition based on published guidelines, and economic evaluations indexed in MEDLINE were mapped to each intervention. A panel of public health and health economics experts discussed the evidence during a workshop and identified evidence gaps.Results: The literature analysis contributed to identifying cross-cutting methodological and technical issues, which were considered by the expert panel to derive methodological research priorities.Conclusions: The panel suggests a research agenda for health economics which incorporates the use of real-world evidence in the assessment of new and existing interventions; increased understanding of cost-effectiveness according to patient characteristics beyond the “-omics” approach to inform both investment and disinvestment decisions; methods for assessment of complex interventions; improved cross-talk between economic evaluations from health and other sectors; early health technology assessment; and standardized, transferable approaches to economic modeling.

scholarly journals Reproducible research practices, openness and transparency in health economic evaluations: study protocol for a cross-sectional comparative analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034463 ◽  
Author(s):  
Ferrán Catalá-López ◽  
Lisa Caulley ◽  
Manuel Ridao ◽  
Brian Hutton ◽  
Don Husereau ◽  
...  
Keyword(s):  
Health Economic ◽  
Comparative Analysis ◽  
Cost Effectiveness ◽  
Random Sample ◽  
Study Protocol ◽  
Reproducible Research ◽  
Economic Evaluations ◽  
Research Practices ◽  
Cross Sectional ◽  
Life Years

IntroductionThere has been a growing awareness of the need for rigorously and transparent reported health research, to ensure the reproducibility of studies by future researchers. Health economic evaluations, the comparative analysis of alternative interventions in terms of their costs and consequences, have been promoted as an important tool to inform decision-making. The objective of this study will be to investigate the extent to which articles of economic evaluations of healthcare interventions indexed in MEDLINE incorporate research practices that promote transparency, openness and reproducibility.Methods and analysisThis is the study protocol for a cross-sectional comparative analysis. We registered the study protocol within the Open Science Framework (osf.io/gzaxr). We will evaluate a random sample of 600 cost-effectiveness analysis publications, a specific form of health economic evaluations, indexed in MEDLINE during 2012 (n=200), 2019 (n=200) and 2022 (n=200). We will include published papers written in English reporting an incremental cost-effectiveness ratio in terms of costs per life years gained, quality-adjusted life years and/or disability-adjusted life years. Screening and selection of articles will be conducted by at least two researchers. Reproducible research practices, openness and transparency in each article will be extracted using a standardised data extraction form by multiple researchers, with a 33% random sample (n=200) extracted in duplicate. Information on general, methodological and reproducibility items will be reported, stratified by year, citation of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement and journal. Risk ratios with 95% CIs will be calculated to represent changes in reporting between 2012–2019 and 2019–2022.Ethics and disseminationDue to the nature of the proposed study, no ethical approval will be required. All data will be deposited in a cross-disciplinary public repository. It is anticipated the study findings could be relevant to a variety of audiences. Study findings will be disseminated at scientific conferences and published in peer-reviewed journals.

scholarly journals Capability instruments in economic evaluations of health-related interventions: a comparative review of the literature

2019 ◽  
Vol 29 (6) ◽  
pp. 1433-1464 ◽  
Author(s):  
Timea Mariann Helter ◽  
Joanna Coast ◽  
Agata Łaszewska ◽  
Tanja Stamm ◽  
Judit Simon
Keyword(s):  
Health Economic ◽  
Psychometric Properties ◽  
Capability Approach ◽  
Economic Evaluations ◽  
Review Of The Literature ◽  
Best Worst Scaling ◽  
Life Years ◽  
Comparative Review ◽  
Health Related ◽  
The Capability Approach

Abstract Purpose Given increasing interest in using the capability approach for health economic evaluations and a growing literature, this paper aims to synthesise current information about the characteristics of capability instruments and their application in health economic evaluations. Methods A systematic literature review was conducted to assess studies that contained information on the development, psychometric properties and valuation of capability instruments, or their application in economic evaluations. Results The review identified 98 studies and 14 instruments for inclusion. There is some evidence on the psychometric properties of most instruments. Most papers found moderate-to-high correlation between health and capability measures, ranging between 0.41 and 0.64. ASCOT, ICECAP-A, -O and -SCM instruments have published valuation sets, most frequently developed using best–worst scaling. Thirteen instruments were originally developed in English and one in Portuguese; however, some translations to other languages are available. Ten economic evaluations using capability instruments were identified. The presentation of results show a lack of consensus regarding the most appropriate way to use capability instruments in economic evaluations with discussion about capability-adjusted life years (CALYs), years of capability equivalence and the trade-off between maximisation of capability versus sufficient capability. Conclusion There has been increasing interest in applying the capability-based approach in health economic evaluations, but methodological and conceptual issues remain. There is still a need for direct comparison of the different capability instruments and for clear guidance on when and how they should be used in economic evaluations.

scholarly journals A New Method for Model-Based Health Economic Evaluation Utilizing and Extending Moment-Generating Functions

2019 ◽  
Vol 39 (5) ◽  
pp. 523-539
Author(s):  
Tristan Snowsill
Keyword(s):  
Health Economic ◽  
Health Effects ◽  
Generating Functions ◽  
Health Economic Evaluation ◽  
New Method ◽  
Economic Evaluations ◽  
Markov Modeling ◽  
Worked Example ◽  
Life Years ◽  
Moment Generating Functions

Background. Health economic evaluations frequently include projections for lifetime costs and health effects using modeling frameworks such as Markov modeling or discrete event simulation (DES). Markov models typically cannot represent events whose risk is determined by the length of time spent in state (sojourn time) without the use of tunnel states. DES is very flexible but introduces Monte Carlo variation, which can significantly limit the complexity of model analyses. Methods. We present a new methodological framework for health economic modeling that is based on, and extends, the concept of moment-generating functions (MGFs) for time-to-event random variables. When future costs and health effects are discounted, MGFs can be used to very efficiently calculate the total discounted life-years spent in a series of health states. Competing risks are incorporated into the method. This method can also be used to calculate discounted costs and health effects when these payoffs are constant per unit time, one-off, or exponential with regard to time. MGFs are extended to additionally support costs and health effects which are polynomial with regard to time (as in a commonly used model of population norms for EQ-5D utility). Worked Example. A worked example is used to demonstrate the application of the new method in practice and to compare it with Markov modeling and DES. Results are compared in terms of convergence and accuracy, and computation times are compared. R code and an Excel workbook are provided. Conclusions. The MGF method can be applied to health economic evaluations in the place of Markov modeling or DES and has certain advantages over both.

scholarly journals Who Conducts Health Economic Evaluations of Laboratory Tests? A Scoping Review

2020 ◽  
Vol 5 (5) ◽  
pp. 954-966
Author(s):  
Isabella Giusepi ◽  
Andrew St John ◽  
Paul Jülicher
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health Economic ◽  
Laboratory Tests ◽  
Clinical Pathways ◽  
Cost Utility ◽  
Medical Laboratory ◽  
Economic Evaluations ◽  
System Perspective ◽  
Life Years

Abstract Background Health economic evaluations (HEEs) are effectively used to inform decision making in healthcare. We sought to assess the level of involvement of laboratory professionals (LPs) in HEEs of laboratory tests. Methods A systematic literature search was conducted in Medline (2013 to November 28, 2018) for original articles reporting HEEs of medical laboratory tests. Eligible studies were characterized by indication, utilization, region, setting, study design, primary outcome measures, and sponsorship. Authors were classified based on stated affiliation as clinician, scientist, public health expert, or LP. Results In total, 140 HEEs were included in the study, of which 24 (17.1%) had contributions from LPs. Studies were primarily focused on infectious disease (n = 68), oncology (n = 23), and cardiovascular disease (n = 16). Cost-utility or cost-effectiveness analyses (n = 117) were the most frequent study types, with effectiveness measured mainly in terms of quality-adjusted life-years (n = 57) and detected cases (n = 41). Overall, 76% of HEEs followed a social or health system perspective, whereas 15% took a hospital viewpoint. Partial or full funding was received from public health organizations or industry in 39% and 16% of studies, respectively. The involvement of LPs was associated with test utilization, secondary care, analytic perspective, and an immediate time horizon (all P < 0.05). Quality of studies was found to be lower in HEEs coauthored by LPs. Conclusion Multidisciplinary collaboration is essential to understanding the complexity of clinical pathways. HEEs are used effectively to inform healthcare decision making. The involvement of LPs in HEEs is low. This implies that laboratory expertise is frequently not considered in decision processes.

The EPA Guidance Project: Guidance for Mental Healthcare in Europe

2015 ◽  
Vol 12 (01) ◽  
pp. 5-11
Author(s):  
I. Großimlinghaus ◽  
J. Zielasek ◽  
W. Gaebel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Graduate Training ◽  
Action Plan ◽  
Stakeholder Involvement ◽  
Mental Healthcare ◽  
World Health ◽  
Post Graduate Training ◽  
Health Organization

Summary Background: The development of guidelines is an important and common method to assure and improve quality in mental healthcare in European countries. While guidelines have to fulfill predefined criteria such as methodological accuracy of evidence retrieval and assessment, and stakeholder involvement, the development of guidance was not standardized yet. Aim: In 2008, the European Psychiatric Association (EPA) initiated the EPA Guidance project in order to provide guidance in the field of European psychiatry and related fields for topics that are not dealt with by guideline developers – for instance due to lack of evidence or lack of funding. The first three series of EPA Guidance deal with diverse topics that are relevant to European mental healthcare, such as quality assurance for mental health services, post-graduate training in mental healthcare, trust in mental health services and mental health promotion. Results: EPA Guidance recommendations address current and future challenges for European psychiatry. They are developed in accordance with the World Health Organization (WHO) European Mental Health Action Plan.

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