scholarly journals A review of public health economic modelling in the National Institute for Health and Care Excellence (NICE)

2020 ◽  
Vol 3 ◽  
pp. 30
Author(s):  
Brian P. Reddy ◽  
Stephen J. Walters ◽  
Praveen Thokala ◽  
Alejandra Duenas ◽  
Michael P. Kelly
Keyword(s):  
Public Health ◽  
Health Economic ◽  
Economic Evaluation ◽  
Economic Models ◽  
Cost Utility ◽  
Economic Modelling ◽  
Reference Case ◽  
Evaluation Approach ◽  
The Given ◽  
Evaluation Techniques

Background: The National Institute for Health and Care Excellence (NICE) use economic modelling to inform judgements whenever further insight is required for decision-making. Doing so for public health guidance poses several challenges. The study’s objective was to investigate the level of heterogeneity in NICE’s public health economic models with regards to economic evaluation techniques, perspectives on outcomes and the measurement of non-health benefits. Methods: A review of all economic modelling reports published by NICE’s Centre for Public Health (CPH) as part of their guidance. Results: The review identified 56 eligible pieces of public health over the relevant period. Of these, 43 used economic modelling and 13 used no formal economic model. In total 61 economic models were used. Though the CPH specifies a reference case, in practice there is a large amount of variability from one model to the next. The most common perspective used for evaluations was that of the National Health Service (NHS); the most common economic evaluation approach was cost-utility analysis (CUA). 23 of the 56 topics used other combinations of perspective and technique, which allowed them to incorporate non-health effects, such as productivity, the effect on taxes raised and benefits spending, costs to the criminal justice sector, the effect on educational attainment and general wellbeing. Conclusions: NICE regularly updates its reference case, and non-CUA evaluation techniques have become more prominent in recent years. The results highlight the genuine advantages of having a variety of economic evaluation techniques available, which can be matched with the given topic. While it is always necessary to be wary of the possibility of gamesmanship and cherry picking, there is a surprising alignment between many approaches in certain circumstances.

Health economic evaluation in ophthalmology

2020 ◽  
pp. bjophthalmol-2020-316880
Author(s):  
Alp Atik ◽  
Keith Barton ◽  
Augusto Azuara-Blanco ◽  
Nathan M Kerr
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
Clinical Decision Making ◽  
Health Economic Evaluation ◽  
Cost Benefit ◽  
Clinical Decision ◽  
Cost Utility ◽  
Economic Modelling ◽  
Increasing Demand ◽  
Healthcare Interventions

Health economic evaluation is the application of economic theories, tools and concepts to healthcare. In the setting of limited resources, increasing demand and a growing array of intervention options, economic evaluation provides a framework for measuring, valuing and comparing the costs and benefits of different healthcare interventions. This review provides an overview of the concepts and methods of economic evaluation, illustrated with examples in ophthalmology. Types of economic evaluation include cost-minimisation, cost-benefit, cost-effectiveness, cost-utility and economic modelling. Topics including utility measures, the quality-adjusted lifeyear, discounting, perspective and timeframe are discussed. Health economic evaluation is important to understand the costs and value of interventions in ophthalmology and to inform health policy as well as guide clinical decision-making.

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

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.

scholarly journals Microsimulation model for the health economic evaluation of osteoporosis interventions: study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e028365
Author(s):  
Lei Si ◽  
John A Eisman ◽  
Tania Winzenberg ◽  
Kerrie M Sanders ◽  
Jacqueline R Center ◽  
...  
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
User Interface ◽  
Economic Model ◽  
Health Economic Evaluation ◽  
Economic Models ◽  
Economic Evaluations ◽  
Microsimulation Model ◽  
Study Results ◽  
Health Economic Model

IntroductionOsteoporosis is a systemic skeletal disease that is characterised by reduced bone strength and increased fracture risk. Osteoporosis-related fractures impose enormous disease and economic burden to the society. Although many treatments and health interventions are proven effective to prevent fractures, health economic evaluation adds evidence to their economic merits. Computer simulation modelling is a useful approach to extrapolate clinical and economic outcomes from clinical trials and it is increasingly used in health economic evaluation. Many osteoporosis health economic models have been developed in the past decades; however, they are limited to academic use and there are no publicly accessible health economic models of osteoporosis.Methods and analysisWe will develop the Australian osteoporosis health economic model based on our previously published microsimulation model of osteoporosis in the Chinese population. The development of the model will follow the recommendations for the conduct of economic evaluations in osteoporosis by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases and the US branch of the International Osteoporosis Foundation. The model will be a state-transition semi-Markov model with memory. Clinical parameters in the model will be mainly obtained from the Dubbo Osteoporosis Epidemiology Study and the health economic parameters will be collected from the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study. Model transparency and validates will be tested using the recommendations from Good Research Practices in Modelling Task Forces. The model will be used in economic evaluations of osteoporosis interventions including pharmaceutical treatments and primary care interventions. A user-friendly graphical user interface will be developed, which will connect the user to the calculation engine and the results will be generated. The user interface will facilitate the use of our model by people in different sectors.Ethics and disseminationNo ethical approval is needed for this study. Results of the model validation and future economic evaluation studies will be submitted to journals. The user interface of the health economic model will be publicly available online accompanied with a user manual.

scholarly journals A Framework for Developing the Structure of Public Health Economic Models

2016 ◽  
Vol 19 (5) ◽  
pp. 588-601 ◽  
Author(s):  
Hazel Squires ◽  
James Chilcott ◽  
Ronald Akehurst ◽  
Jennifer Burr ◽  
Michael P. Kelly
Keyword(s):  
Public Health ◽  
Health Economic ◽  
Economic Models

Applied Health Economics for Public Health Practice and Research

2019 ◽  
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Health Economics ◽  
Case Studies ◽  
Population Health ◽  
Evidence Synthesis ◽  
Health Interventions ◽  
Public Healthcare ◽  
Economic Modelling ◽  
Public Health Interventions

Public health has been described as the organized activities of society to improve and protect the health of the population. Health economics applied to public health is the study of how we allocate our scarce societal resources to meet our public health wants and needs in the best way possible. This book presents current thinking on health economics methodology and application to the evaluation of public health interventions (PHIs). It is for health economists working in higher education and public healthcare systems, challenged with the economic evaluation of PHIs, when they have been used to applying health economics and the methods of economic evaluation to narrower clinical interventions in primary or secondary care settings. This book will also be of interest to public health practitioners wanting to incorporate health economics into their daily work. This book covers the history of economics of public health and the economic rationale for government investment in prevention; principles of health economics including scarcity, choice, and opportunity cost; evidence synthesis; key methods of economic evaluation with accompanying case studies; economic modelling of public health interventions; return on investment analysis with national and international case studies; and application of programme budgeting and marginal analysis (PBMA) to the prioritization of PHIs. It concludes with priorities for research in the field of public health economics, spanning an acknowledgement of the role played by the natural environment in promoting better health, through to precision public health, recognizing the role of genetics, the environment, and socioeconomic status in determining population health.

scholarly journals Incorporation of a health economic modelling tool into public health commissioning: Evidence use in a politicised context

2017 ◽  
Vol 186 ◽  
pp. 122-129 ◽  
Author(s):  
Tom Sanders ◽  
Amy Grove ◽  
Sarah Salway ◽  
Susan Hampshaw ◽  
Elizabeth Goyder
Keyword(s):  
Public Health ◽  
Health Economic ◽  
Economic Modelling ◽  
Evidence Use ◽  
Health Economic Modelling

Quality appraisal of pediatric health economic evaluations

2005 ◽  
Vol 21 (2) ◽  
pp. 203-210 ◽  
Author(s):  
Wendy J. Ungar ◽  
Maria T. Santos
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
Target Population ◽  
Poor Quality ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Global Rating ◽  
Quality Appraisal ◽  
Pediatric Health ◽  
Economic Methods

Objectives: This study was undertaken to appraise the quality of published pediatric economic evaluations.Methods: Two independent reviewers appraised 149 randomly selected pediatric health economic studies. Data were collected from full economic evaluations published between 1980 and 1999. Economic evaluations of interventions, programs, and services aimed at neonates to adolescents were included. The Pediatric Quality Appraisal Questionnaire (PQAQ) was used for appraisal. The PQAQ is a 57-item instrument with 13 domains scored from 0 to 1 and one descriptive domain, each corresponding to a key aspect of health economic methodology. The primary outcome was the score for each domain. Additional analyses examined the global rating, the distribution of analytic technique, and the association between domain score and analytic technique.Results: A total of 38 percent of publications were very good to excellent, whereas 43 percent were fair or worse. Although the Discounting, Target Population, Economic Evaluation, Conclusions, and Comparators domains exhibited good quality (0.74 to 0.78), the papers were of poor quality for Conflict of Interest, Incremental Analysis, and Perspective (0.32 to 0.39). Analytic technique was a significant predictor of quality for study design-related domains, with cost-utility analyses demonstrating the highest domain scores.Conclusions: Domains closely related to the elements of economic evaluation demonstrated medium to high quality. However, domains related to analysis fared poorly and are worthy of further methodological research to improve the use of health economic methods in children.

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