scholarly journals How not to count the health benefits of family planning

2021 ◽  
pp. medethics-2021-107668
Author(s):  
Jacob Zionts ◽  
Joseph Millum
Keyword(s):  
Health Economic ◽  
Family Planning ◽  
Economic Evaluations ◽  
Study Group ◽  
Costs And Benefits ◽  
Value Judgments ◽  
Value Judgment ◽  
Scarce Resources ◽  
Child Deaths ◽  
Economic Analyses

Several influential organisations have attempted to quantify the costs and benefits of expanding access to interventions—like contraceptives—that are expected to decrease the number of pregnancies. Such health economic evaluations can be invaluable to those making decisions about how to allocate scarce resources for health. Yet how the benefits should be measured depends on controversial value judgments. One such value judgment is found in recent analyses from the Disease Control Priority Network (DCPN) and the Study Group for the Global Investment Framework for Women’s and Children’s Health. Noting the decrease in the number of pregnancies expected to result from providing access to family planning, DCPN and the Study Group claim that a substantial benefit of such interventions is averting the stillbirths and child deaths that would have resulted from those pregnancies. We argue that health economic analyses should not count such averted deaths as benefits in the same way as saved lives. First, by counting averted stillbirths and child deaths as a benefit but not counting as a cost the lives of babies who survive, DCPN and the Study Group implicitly commit themselves to antinatalism. Second, this method for calculating the benefits of family planning interventions implies that infertility treatments are harmful. Determining how potential people should be treated in health economic analyses will require grappling with population ethics.

Health economic analysis of service provision

2020 ◽  
pp. 1384-1391
Author(s):  
Judit Simon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Economic ◽  
National Income ◽  
Health Spending ◽  
Health Economic Analysis ◽  
Policy Makers ◽  
Scarce Resources ◽  
Economic Methods ◽  
Economic Analyses

Resources available in the health care system are limited and are exceeded by needs. Public health and long-term care expenditures have been rising steadily, relative to national income, for several decades. Currently, the costs of mental ill-health account for up to 14% of health spending in Organisation for Economic Co-operation and Development (OECD) countries, and this proportion is also expected to rise further. Decisions on how best to allocate scarce resources are therefore becoming increasingly prominent among health policy-makers with specific relevance to mental health services. This chapter summarizes the health economic methods used to inform the key questions of decision-makers in health care related to efficiency and equity. It provides an explanation of the underlying economic and analytical frameworks and gives a summary of the different techniques of health economic analyses, supported by a selection of recent relevant published examples from the mental health field.

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.

Gezondheidseconomische evaluaties binnen een preventief beleid: een kritische introductie

2021 ◽  
Author(s):  
A. WERBROUCK ◽  
L. ANNEMANS ◽  
N. VERHAEGHE ◽  
S. SIMOENS
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Health Effects ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Decision Analytic Model ◽  
To Come ◽  
Economic Analyses ◽  
Preventive Policy

Health-economic evaluations in preventive policy: a critical introduction. The Flemish prevention decree specifies that policy initiatives should maximize health gains at a socially acceptable cost. As health-economic evaluations aim to evaluate the expected health effects as well as the expected costs of interventions, this type of studies can be considered indispensable to come to evidence-based policy. The goal of this paper is to introduce the basic aspects of health-economic evaluations, with a focus on preventive interventions. Although the term cost-effectiveness is often used as an umbrella term, technically speaking there is a distinction between cost-effectiveness studies and cost-utility studies. In the latter case, Belgium and many other countries often use the quality-adjusted life year (QALY) to assess health effects. Health-economic analyses can either be performed alongside a clinical trial, or by the use of a decision-analytic model in which different sources are combined to estimate long-term costs and health effects. How do we handle the effects of prevention in the (sometimes far) future? What is the optimal target group? What about the uncertainty within cost-effectiveness analyses? Can health inequity be incorporated? Several aspects of health-economic evaluations require sufficient attention when analysing preventive policy.

scholarly journals Bridging the Gap between Evidence and Practice for Adults with Medically Refractory Temporal Lobe Epilepsy: Is a Change in Funding Policy Needed to Stimulate a Shift in Practice?

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Alireza Mansouri ◽  
Abdulrahman Aldakkan ◽  
Magda J. Kosicka ◽  
Jean-Eric Tarride ◽  
Taufik A. Valiante
Keyword(s):  
Health Economic ◽  
Refractory Epilepsy ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Funding Policy ◽  
Policy Changes ◽  
Limited Success ◽  
Comprehensive Health ◽  
Economic Analyses

Objective. Surgery for medically refractory epilepsy (MRE) in adults has been shown to be effective but underutilized. Comprehensive health economic evaluations of surgery compared with continued medical management are limited. Policy changes may be necessary to influence practice shift. Methods. A critical review of the literature on health economic analyses for adults with MRE was conducted. The MEDLINE, EMBASE, CENTRAL, CRD, and EconLit databases were searched using relevant subject headings and keywords pertaining to adults, epilepsy, and health economic evaluations. The screening was conducted independently and in duplicate. Results. Four studies were identified (1 Canadian, 2 American, and 1 French). Two were cost-utility analyses and 2 were cost-effectiveness evaluations. Only one was conducted after the effectiveness of surgery was established through a randomized trial. All suggested surgery to be favorable in the medium to long term (7-8 years and beyond). The reduction of medication use was the major cost-saving parameter in favor of surgery. Conclusions. Although updated evaluations that are more generalizable across settings are necessary, surgery appears to be a favorable option from a health economic perspective. Given the limited success of knowledge translation endeavours, funder-level policy changes such as quality-based purchasing may be necessary to induce a shift in practice.

EXPRESS: Health economic evaluations of medical tests: translating laboratory information into value- a case study example

2021 ◽  
pp. 000456322110138
Author(s):  
Paul Jülicher ◽  
Maurice O'Kane ◽  
Christopher P. Price ◽  
Robert H Christenson ◽  
Andrew St John
Keyword(s):  
Health Economic ◽  
Healthcare Providers ◽  
Economic Assessment ◽  
Assessment Tools ◽  
Economic Evaluations ◽  
Economic Modelling ◽  
Scarce Resources ◽  
Key Stakeholders ◽  
Analytic Models ◽  
Health Economic Modelling

Healthcare providers and funders are focused on identifying value in all their services and that includes laboratories. This means that in order to gain a share of scarce resources laboratory professionals must also understand and assess the value of tests and that includes their economic impact. This can be assessed using health economic modelling tools which, when used in conjunction with a detailed value proposition for the test, can translate laboratory information into value. While a variety of health economic assessment tools are available this review will focus on the use of decision analytic models which essentially compare the outcomes from pathways with and without the new test, the value of which is being assessed. A step-by-step framework is provided to guide laboratory professionals through the essential steps of conducting the evaluation. Initial steps include mapping the clinical pathway, understanding the goal of the evaluation, identifying the key stakeholders and their needs and determining a suitable analytical model. Following collection of the actual data, the validity of the model must be checked, and the robustness of the outcomes tested through sensitivity analysis. The last step is to translate the findings into measures of value which can then inform appropriate decisions by the stakeholders. This review of basic health economic modelling should enable laboratory professionals to have an understanding of how modelling can be applied to tests in their own environment and help deliver their potential value.

Improving the quality of abstract reporting for economic analyses in oncology.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 109-109
Author(s):  
Maria Yi Ho ◽  
Kelvin Chan ◽  
Stuart Peacock ◽  
Winson Y. Cheung
Keyword(s):  
Health Economic ◽  
Time Horizon ◽  
Quality Score ◽  
Costs And Benefits ◽  
Expert Rating ◽  
Economic Analyses ◽  
The Cost ◽  
Abstract Reporting ◽  
Over Time

109 Background: Increasing costs of cancer drugs underscore the importance of EA, which convey key information about the relative costs and benefits of new interventions. Although guidelines for abstracts exist for phase I, II, and III oncology trials, similar recommendations for EA are lacking. Our objectives were to 1) identify items considered to be essential for EA abstracts; 2) evaluate the quality of EA abstracts submitted to ASCO, ASH, and ISPOR meetings; and 3) propose guidelines for future reporting. Methods: Health economic experts were surveyed and asked to rate each of 24 possible EA elements on a 5-point Likert scale. A scoring system for abstract quality (0=poor and 100=excellent) was devised based on EA elements with an average expert rating ≥ 3.5. All EA abstracts from ASCO (‘97–‘09), ASH (‘04–‘09) and ISPOR (‘97–‘09) were reviewed and assigned a quality score. Results: Of 99 experts surveyed, 50 (51%) responded. Characteristics of respondents: average age = 53; male = 78%; US / Europe / Canada = 54% / 28% / 18%. A total of 216 abstracts were reviewed: ASCO 53%, ASH 14% and ISPOR 33%. Median quality score was 75 (range 48 to 93), but notable deficiencies were observed. For instance, the cost perspective of the EA was reported in only 61% of abstracts, while the time horizon was described in only 47%. An association was seen between year of presentation and overall quality of abstracts (p=0.001), with those from recent years demonstrating better quality scores. There were also disparities in quality scores among EA of different cancer sites (p=0.005). Conclusions: Quality of EA abstracts for oncology has improved over time, but there is room for improvement. Abstracts may be enhanced using guidelines derived from our survey of experts (see table). [Table: see text]

scholarly journals Health economic measures in schizophrenia research

2007 ◽  
Vol 191 (S50) ◽  
pp. s42-s45 ◽  
Author(s):  
Paul McCrone
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
Cost Utility ◽  
Outcome Data ◽  
Cost Utility Analysis ◽  
Economic Evaluations ◽  
Utility Analysis ◽  
Short Term ◽  
Effectiveness Analysis

BackgroundIt is essential in economic evaluations of schizophrenia interventions that all relevant costs are identified and measured appropriately Also of importance is the way in which cost data are combined with information on outcomesAimsTo examine the use of health economicsin evaluations of interventions for schizophreniaMethodsAreview of the key methods used to estimate costs and to link costs and outcomes was conductedResultsCosts fall on a number of different agencies and can be short term or long term. Cost-effectiveness analysis and cost-utility analysis are the most appropriate methods for combing cost and outcome dataConclusionsSchizophrenia poses a number of challenges for economic evaluation

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