Economic evaluation and priority setting: an overview

Author(s):  
Jan Abel Olsen

This chapter provides an overview of the methodologies that come under the umbrella term of economic evaluation in healthcare. Economic evaluations seek to identify, measure, value, and compare alternative programmes. A taxonomy is developed to distinguish economic evaluation techniques depending on whether benefits have been measured in money terms or not, and whether benefits are based on preferences or not. When benefits are measured in money terms, it is referred to as a cost–benefit analysis (CBA). If benefits are measured in health terms, some sort of cost-effectiveness analysis (CEA) is being used. An important class of CEA is what has come to be labelled ‘cost-utility-analysis’ (CUA). The chapter explains the incremental cost-effectiveness ratio (ICER) and illustrates the cost-effectiveness plane. Finally, the idea of discounting health is discussed.

2021 ◽  
Vol 9 ◽  
Author(s):  
Mayara Fontes Marx ◽  
John E. Ataguba ◽  
Jantina de Vries ◽  
Ambroise Wonkam

Objectives: Discussions regarding who and how incidental findings (IFs) should be returned and the ethics behind returning IFs have increased dramatically over the years. However, information on the cost and benefits of returning IFs to patients remains scanty.Design: This study systematically reviews the economic evaluation of returning IFs in genomic sequencing. We searched for published articles on the cost-effectiveness, cost-benefit, and cost-utility of IFs in Medline, Scopus, PubMed, and Google Scholar.Results: We found six published articles that met the eligibility criteria of this study. Two articles used cost analysis only, one used cost-benefit analysis only, two used both cost analysis and cost-effectiveness, and one used both cost-benefit analysis and cost-utility to describe the cost of returning IFs in genomic sequencing.Conclusion: While individuals value the IF results and are willing to pay for them, the cost of returning IFs depends on the primary health condition of the patient. Although patients were willing to pay, there was no clear evidence that returning IFs might be cost-effective. More rigorous economic evaluation studies of IFs are needed to determine whether or not the cost of returning IFs is beneficial to the patient.


1989 ◽  
Vol 34 (7) ◽  
pp. 633-636 ◽  
Author(s):  
Bruce J. Fried ◽  
Catherine Worthington ◽  
Raisa B. Deber

Economic evaluation is becoming an increasingly important part of the evaluation of health and mental health services. Current models for conducting economic evaluation, including cost-effectiveness analysis, cost-benefit analysis, and cost-utility analysis, have great potential for improving the quality of decision-making and for making mental health programs more effective and efficient. This paper presents the basic economic theory underlying the various forms of economic evaluation and provides general guidelines for developing and conducting an economic analysis of a health program.


Author(s):  
Arsalan Sarmad ◽  
B. Syed Salman ◽  
Syed Sharfuddin Ibrahim

Cost-benefit analysis can be used to quantify the value of clinical pharmacy services. Providing Effective Therapy and Minimum cost, Quantify costs of care, Quantify outcomes, Assess whether and by how much average costs and outcomes differ among treatment groups, Compare magnitude of difference in costs and outcomes and evaluate “value for costs” by reporting a cost-effectiveness ratio, net monetary benefit, or probability that ratio is acceptable – Potential hypothesis: Cost per quality-adjusted life year saved significantly less than Rs.75,000, To Perform sensitivity analysis. For providing good effective therapy with less adverse drug reaction at affordable price, Cost-Identification, Cost-Effectiveness Analysis, Cost-Utility Analysis, Cost-Benefit Analysis, Clinical outcomes: Cure, comfort and survival, Humanistic outcomes: Physical, emotional, social function, role performance, Economic outcomes, Economic Evaluation, Cost of Illness Evaluation (COI), Cost Benefit Analysis (CBA), Cost Minimization Analysis, Cost Effective Analysis: Cost Utility Analysis.


1995 ◽  
Vol 11 (2) ◽  
pp. 365-376 ◽  
Author(s):  
Brian E. Rittenhouse

AbstarctThis paper indicates that certain economic evaluation methods (cost-effectiveness and cost-utility analyses) may yield inconsistent results. Along with the lack of formal grounding of these methods in economic “first principles,” this finding suggests the possible benefit of greater reliance on the more formally developed method of cost-benefit analysis.


2018 ◽  
Vol 10 (12) ◽  
pp. 4668 ◽  
Author(s):  
Antonio Nesticò ◽  
Shuquan He ◽  
Gianluigi De Mare ◽  
Renato Benintendi ◽  
Gabriella Maselli

The process of allocating financial resources is extremely complex—both because the selection of investments depends on multiple, and interrelated, variables, and constraints that limit the eligibility domain of the solutions, and because the feasibility of projects is influenced by risk factors. In this sense, it is essential to develop economic evaluations on a probabilistic basis. Nevertheless, for the civil engineering sector, the literature emphasizes the centrality of risk management, in order to establish interventions for risk mitigation. On the other hand, few methodologies are available to systematically compare ante and post mitigation design risk, along with the verification of the economic convenience of these actions. The aim of the paper is to demonstrate how these limits can be at least partially overcome by integrating, in the traditional Cost-Benefit Analysis schemes, the As Low as Reasonably Practicable (ALARP) logic. According to it, the risk is tolerable only if it is impossible to reduce it further or if the costs to mitigate it are disproportionate to the benefits obtainable. The research outlines the phases of an innovative protocol for managing investment risks. On the basis of a case study dealing with a project for the recovery and transformation of an ancient medieval village into a widespread-hotel, the novelty of the model consists of the characterization of acceptability and tolerability thresholds of the investment risk, as well as its ability to guarantee the triangular balance between risks, costs and benefits deriving from mitigation options.


1994 ◽  
Vol 10 (4) ◽  
pp. 675-682 ◽  
Author(s):  
Magnus Johannesson

AbstractThe costs included in economic evaluations of health care vary from study to study. Based on the theory of cost-benefit analysis, the costs that should be included in an economic evaluation are those not already included in the measurement of willingness to pay (net willingness to pay above any treatment costs paid by the individual) in a cost-benefit analysis or in the easurement of effectiveness in a cost-effectiveness analysis. These costs can be defined as the onsumption externality of the treatment (the change in production minus consumption for those included in the treatment program). For a full economic evaluation, the consequences for those included in the treatment program and a caring externality (altruism) should also be added.


2021 ◽  
Vol 38 (4) ◽  
pp. 312-319
Author(s):  
Ha-Na Kim ◽  
Jun-Yeon Kim ◽  
Kyeong-Ju Park ◽  
Ji-Min Hwang ◽  
Jun-Yeong Jang ◽  
...  

Background: Lumbar herniated intervertebral disc (LHIVD) is a frequently presented condition/disease in Korean medical institutions. In this study, the economics of thread embedding acupuncture (TEA) was evaluated in a randomized controlled trial comparing TEA with sham TEA (STEA).Methods: This economic evaluation was analyzed from a limited social perspective, and the per-protocol set was from a basic analysis perspective. The cost-effectiveness analysis was based on the change in visual analog scale score, and the cost-utility analysis was based on the quality-adjusted life years. The final results were expressed as the average cost-effectiveness ratio and incremental cost-effectiveness ratio, and furthermore sensitivity analysis was performed to confirm the robustness of the results observed.Results: The cost-effectiveness analysis showed that TEA was 9,908 won lower than STEA, while the decrease in 100 mm visual analog scale score was 8.5 mm greater in the TEA group compared with the STEA group (p > 0.05). The cost-utility analysis showed that TEA was 9,908 won lower than STEA, while the quality-adjusted life years of TEA was 0.0026 years higher than STEA (p > 0.05). These results were robust in the sensitivity analysis, but were not statistically significant.Conclusion: In treating LHIVD, TEA appeared to have cost-effectiveness and cost-utility compared with STEA. However, there were no significant differences between the groups in terms of cost, effectiveness, and utility indicators. Therefore, results must be interpreted prudently; this study was the 1st to conduct an economic evaluation of TEA for LHIVD.


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