scholarly journals An overview of systematic reviews of economic evaluations of pharmacy-based public health interventions: addressing methodological challenges

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Suzete Costa ◽  
Maria Cary ◽  
Dennis K. Helling ◽  
João Pereira ◽  
Céu Mateus
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Systematic Reviews ◽  
Quality Criteria ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Synthesis Methods ◽  
Public Health Interventions ◽  
Overview Of Systematic Reviews ◽  
Pharmacy Interventions

Abstract Background Pharmacy interventions are a subset of public health interventions and its research is usually performed within the scope of a trial. The economic evaluation of pharmacy interventions requires certain considerations which have some similarities to those of public health interventions and to economic evaluations alongside trials. The objective of this research is to perform an overview of systematic reviews of economic evaluations of pharmacy services and triangulate results with recommendations for economic evaluations of both public health interventions and alongside trials. Methods (1) Exploratory review of recommendations on the economic evaluation of public health interventions, (2) exploratory review of recommendations for conducting economic evaluations alongside trials, (3) overview of systematic reviews of economic evaluations of pharmacy interventions (protocol registered with PROSPERO 2016 outlining information sources, inclusion criteria, appraisal of reviews and synthesis methods). Results Fourteen systematic reviews containing 75 index publications were included. Reviews reported favorable economic findings for 71% of studies with full economic evaluations. The types of economic analysis are diverse. Two critical quality domains are absent from most reviews. Key findings include the following: certain types of risk of bias, wider scope of study designs, and most economic quality criteria met but some issues unresolved or unclear. Triangulation revealed additional gaps. Limitations include choice of critical quality domains and potential biases in the overview process. Conclusions Economic evaluations of pharmacy-based public health interventions seem to follow most economic quality criteria, but there are still some issues in certain key areas to improve. These findings may assist in improving the design of pilot trials of economic evaluations in pharmacy, leading to robust evidence for payers. Based on the findings, we propose a methodological approach for the economic evaluation of pharmacy-based public health interventions. Systematic review registration PROSPERO CRD42016032768

Identification, measurement, and valuation of resource use in economic evaluations of public health interventions

2019 ◽  
pp. 107-130 ◽  
Author(s):  
Carys Jones ◽  
Joanna M. Charles ◽  
Rhiannon T. Edwards
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Good Practice ◽  
Public Health Intervention ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Public Health Interventions ◽  
Cost Information ◽  
Worked Example ◽  
Unit Costs

Chapter 5 provides a practical guide to the types of costs relevant to an economic evaluation of a public health intervention, perspective of analysis, and sources of unit costs spanning a range of sectors including health, social care, education, and transport. The chapter covers the important issues of time horizon and discounting in the economic evaluation of public health interventions. Taking account of sources of uncertainty, the chapter sets out good practice in reporting cost information in published economic studies. The chapter concludes with a worked example of a micro-costing of a parenting programme delivered in the community.

Synthesizing evidence for economic evaluations of public health interventions

2019 ◽  
pp. 87-106
Author(s):  
Olivia Wu ◽  
Joanna M. Charles ◽  
Nathan Bray
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Evidence Synthesis ◽  
Good Practice ◽  
Relevant Literature ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Narrative Synthesis ◽  
Public Health Interventions

Reviewing and synthesizing evidence is an important component of the toolkit of methods for the economic evaluation of PHIs. Chapter 4 provides readers with information about good practice in identifying relevant literature, judging the quality of relevant literature, and synthesizing evidence for economic evaluations of PHIs. Narrative synthesis has become a key focus in synthesizing complex PHIs. Readers are also introduced to the idea that logic (conceptual) models can be helpful in describing processes and hence outcomes. The chapter goes on to describe mixed-method reviews, realist synthesis, other forms of evidence synthesis, and equity considerations.

The use of modelling approaches for the economic evaluation of public health interventions

2019 ◽  
pp. 248-278
Author(s):  
Hazel Squires ◽  
Kathleen Boyd
Keyword(s):  
Public Health ◽  
Health Economic ◽  
Economic Evaluation ◽  
Health Economic Evaluation ◽  
Health Interventions ◽  
Primary Data ◽  
Public Health Interventions ◽  
Modelling Framework ◽  
Decision Analytic Modelling ◽  
Complex Relationships

This chapter considers the use of modelling for public health economic evaluation. The approach to decision analytic modelling within health economic evaluation is described and five key challenges relating to modelling public health interventions are highlighted: incorporating equity; extrapolating multi-component intervention effectiveness beyond study data; capturing relevant complex relationships and feedback loops of a dynamically complex system; modelling human behaviour; and capturing relevant non-health costs and outcomes and the relationship between individual and social determinants. The chapter describes current practice and the latest methodological research in these areas. It outlines two general approaches which could help to address these challenges by (i) adopting an iterative approach to the evaluation by using early-stage decision modelling to guide primary data collection, and (ii) a conceptual modelling framework to guide the model development process.

Health Technology Assessment of Public Health Interventions Published 2012 to 2016: An Analysis of Characteristics and Comparison of Methods

2019 ◽  
Vol 35 (4) ◽  
pp. 280-290 ◽  
Author(s):  
Stephanie Polus ◽  
Tim Mathes ◽  
Corinna Klingler ◽  
Melanie Messer ◽  
Ansgar Gerhardus ◽  
...  
Keyword(s):  
Public Health ◽  
A Priori ◽  
Health Technology ◽  
Legal Aspects ◽  
Population Based ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Public Health Interventions ◽  
Comprehensive Overview ◽  
Cultural Aspects

AbstractObjectivesThe aim of this study was to provide an overview of the methodological characteristics and compare the assessment methods applied in health technology assessments (HTAs) of public health interventions (PHIs).MethodsWe defined a PHI as a population-based intervention on health promotion or for primary prevention of chronic or nonchronic diseases. HTAs on PHIs were identified by systematically searching the Web pages of members of international HTA networks. We included only full HTA reports published between 2012 and 2016. Two reviewers extracted data on the methods used to assess effectiveness/safety, as well as on economic, social, cultural, ethical, and legal aspects using a-priori standardized tables.ResultsWe included ten HTAs provided by four different organizations. Of these, all reports assessed the effectiveness of the interventions and conducted economic evaluations, seven investigated social/cultural aspects, and four each considered legal and ethical aspects, respectively. Some reports addressed applicability, context/setting, and intervention fidelity issues in different ways. We found that most HTAs adapted their methods to some extent, for example, by including nonrandomized studies, expanding the search strategy, involving stakeholders, or applying a framework to guide the HTA process.ConclusionsOur analysis provides a comprehensive overview of methods applied in HTAs on public health interventions. We found that a heterogeneous set of approaches is used to deal with the challenges of evaluating complex public health interventions.

scholarly journals It's in your hands: the value of handsearching in conducting systematic reviews of public health interventions

2005 ◽  
Vol 27 (4) ◽  
pp. 388-391 ◽  
Author(s):  
R. Armstrong ◽  
N. Jackson ◽  
J. Doyle ◽  
E. Waters ◽  
F. Howes
Keyword(s):  
Public Health ◽  
Systematic Reviews ◽  
Health Interventions ◽  
Public Health Interventions

The Economics of Infectious Diseases

2018 ◽  
Author(s):  
Katharina Hauck
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Disease Transmission ◽  
Health Interventions ◽  
Health System Strengthening ◽  
Economic Research ◽  
Economic Evaluations ◽  
Research Needs ◽  
Public Health Interventions ◽  
The Impact

Economics can make immensely valuable contributions to our understanding of infectious disease transmission and the design of effective policy responses. The one unique characteristic of infectious diseases makes it also particularly complicated to analyze: the fact that it is transmitted from person to person. It explains why individuals’ behavior and externalities are a central topic for the economics of infectious diseases. Many public health interventions are built on the assumption that individuals are altruistic and consider the benefits and costs of their actions to others. This would imply that even infected individuals demand prevention, which stands in conflict with the economic theory of rational behavior. Empirical evidence is conflicting for infected individuals. For healthy individuals, evidence suggests that the demand for prevention is affected by real or perceived risk of infection. However, studies are plagued by underreporting of preventive behavior and non-random selection into testing. Some empirical studies have shown that the impact of prevention interventions could be far greater than one case prevented, resulting in significant externalities. Therefore, economic evaluations need to build on dynamic transmission models in order to correctly estimate these externalities. Future research needs are significant. Economic research needs to improve our understanding of the role of human behavior in disease transmission; support the better integration of economic and epidemiological modeling, evaluation of large-scale public health interventions with quasi-experimental methods, design of optimal subsidies for tackling the global threat of antimicrobial resistance, refocusing the research agenda toward underresearched diseases; and most importantly to assure that progress translates into saved lives on the ground by advising on effective health system strengthening.

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