What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?

The ‘conventional framework’ of economic evaluation, the comparative public sector healthcare costs and quality adjusted life year (QALY) of two or more interventions, has become synonymous with commissioning decisions in many countries. However, while useful as a framework in guiding value-based decisions, it has limited relevance in areas such as end of life care in children and young people, where the costs fall across multiple stakeholders and QALY gains are not the primary outcome. This paper makes the case that the restricted relevance of the ‘conventional framework’ has contributed to the inconsistent and varied provision of care in this setting, and to the knock-on detrimental impact on children nearing the end of their lives as well as their families. We explore the challenges faced by those seeking to conduct economic evaluations in this setting alongside some potential solutions. We conclude that there is no magic bullet approach that will amalgamate the ‘conventional framework’ with the requirements of a meaningful economic evaluation in this setting. However, this does not imply a lack of need for the summation of the costs and outcomes of care able to inform decision makers, and that methods such as impact inventory analysis may facilitate increased flexibility in economic evaluations.

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The purpose and scope of this book

10.1093/med/9780198725923.003.0001 ◽

2016 ◽

Author(s):

John Brazier ◽

Julie Ratcliffe ◽

Joshua A. Salomon ◽

Aki Tsuchiya

Keyword(s):

Health Care ◽

Economic Evaluation ◽

Quality Adjusted Life Year ◽

Economic Evaluations ◽

Pharmaceutical Companies ◽

Governmental Agencies ◽

Health Practitioners ◽

Intangible Benefits ◽

Private Research ◽

Quality Adjusted Life

This book provides the reader with an in-depth knowledge of one of the two key elements of economic evaluation in health care. It is written as a textbook which aims to include a comprehensive coverage of topics, while also being up-to-date at the time of going to press. It helps meet an important need that has been generated by the establishment of the National Institute for Health and Care Excellence (NICE) and similar international bodies requiring cost-effectiveness evidence in the form of incremental cost per quality-adjusted life year (QALY). It is aimed at academics and students of health economics as well as others concerned with the valuation of intangible benefits, such as: health practitioners from economics and other disciplines engaged in generating economic evaluations for research bodies; governmental agencies in health care (such as NICE); non-health care agencies whose programmes affect health; and pharmaceutical companies and private research consultancies.

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Challenges for Economic Evaluation of Health Care Strategies to Contain Antimicrobial Resistance

Antibiotics ◽

10.3390/antibiotics8040166 ◽

2019 ◽

Vol 8 (4) ◽

pp. 166 ◽

Cited By ~ 3

Author(s):

Emily A. F. Holmes ◽

Dyfrig A. Hughes

Keyword(s):

Health Care ◽

Economic Evaluation ◽

Antimicrobial Resistance ◽

Health Care Providers ◽

Quality Adjusted Life Year ◽

Economic Evaluations ◽

Antibiotic Prescribing ◽

Care Providers ◽

Short Term ◽

Health Care Interventions

The threat of antimicrobial resistance has global health and economic consequences. Medical strategies to reduce unnecessary antibiotic prescribing, to conserve the effectiveness of current antimicrobials in the long term, inevitably result in short-term costs to health care providers. Economic evaluations of health care interventions therefore need to consider the short-term costs of interventions, to gain future benefits. This represents a challenge for health economists, not only in terms of the most appropriate methods for evaluation, but also in attributing the potential budget impact over time and considering health impacts on future populations. This commentary discusses the challenge of accurately capturing the cost-effectiveness of health care interventions aimed at tackling antimicrobial resistance. We reflect on methods to capture and incorporate the costs and health outcomes associated with antimicrobial resistance, the appropriateness of the quality-adjusted-life year (QALY), individual time preferences, and perspectives in economic evaluation.

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Resource allocation and economic evaluation in Australia's healthcare system

Australian Health Review ◽

10.1071/ah10890 ◽

2011 ◽

Vol 35 (3) ◽

pp. 278 ◽

Cited By ~ 11

Author(s):

Abdolvahab Baghbanian ◽

Ian Hughes ◽

Freidoon A. Khavarpour

Keyword(s):

Decision Making ◽

Resource Allocation ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Decision Makers ◽

Economic Evaluations ◽

Healthcare Decision ◽

Effectiveness Analysis ◽

Allocation Decisions ◽

Resource Allocation Decisions

Objective. To explore dimensions and varieties of economic evaluations that healthcare decision-makers do or do not use. Design. Web-based survey. Setting and participants. A purposive sample of Australian healthcare decision-makers was recruited by direct invitation through email. All were invited to complete an online questionnaire derived from the EUROMET 2004 survey. Results. A total of 91 questionnaires were analysed. Almost all participants were involved in financial resource allocations. Most commonly, participants based their decisions on patient needs, effectiveness of interventions, cost of interventions or overall budgetary effect, and policy directives. Evidence from cost-effectiveness analysis was used by half of the participants. Timing, ethical issues and lack of knowledge about economic evaluation were the most significant barriers to the use of economic evaluations in resource allocation decisions. Most participants reported being moderately to very familiar with the cost-effectiveness analysis. There was a general impression that evidence from economic evaluations should play a larger role in the future. Conclusions. Evidence from health economic evaluations may provide valuable information in some decisions; however, at present, it is not central to many decisions. The study suggests that, for economic evaluation to be helpful in real-life policy decisions, it has to be placed into context – a context which is complex, political and often resistant to voluntary change. What is known about the topic? There are increasing calls for the use of evidence from formal economic evaluations to improve the quality of healthcare decision making; however, it is widely acknowledged that such evidence, as presently constituted, is underused in its influence on allocation decisions. What does this paper add? This study highlights that resource allocation decisions cannot be purely based on the use of technical, economic data or systematic evidence-based reviews. In order to exploit the full potential value of economic evaluations, researchers need to make better sense of decision contexts at specific times and places. What are the implications for practitioners? The study has the potential to expand researchers and policy-makers’ understanding of the limited use of economic evaluation in decision-making. It produces evidence that decision-making in Australia’s healthcare system is not or cannot be a fully rational bounded process. Economic evaluation is used in some contexts, where information is accurate, complete and available.

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VP13 Transferability Instrument Of Health Economic Evaluations For Chile

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319002903 ◽

2019 ◽

Vol 35 (S1) ◽

pp. 78-78

Author(s):

Victoria Hurtado-Meneses ◽

Catherine De la Puente ◽

Marianela Castillo ◽

Sergio Poblete

Keyword(s):

Economic Evaluation ◽

De Novo ◽

Research Question ◽

Cost Effective ◽

Decision Makers ◽

Economic Evaluations ◽

Reference Case ◽

Knock Out ◽

Cost Treatment ◽

Assess Quality

IntroductionAny technology submission for the high-cost treatment fund in Chile requires an economic evaluation; however, this is time consuming and given its high number, it is not possible to inform decisions within the established period of time. This presentation proposes a guide for the transferability of international economic evaluation results to our national context, with the intention to inform decision makers in a brief period of time.MethodsA literature review on transferability analysis, tools and instruments to perform transferability analysis and on how to assess quality of economic evaluations was conducted. In addition, a workshop was held to discuss the proposal with other relevant researchers, in order to receive feedback.ResultsThe proposed instrument is based on Welte and consists of: (i) a research question is formulated and a systematic review of economic evaluations is conducted, (ii) the three Welte knock-out criteria are applied to these results and, if these are met, the articles pass to the next stage, (iii) a scored comparison based on twelve criteria is conducted on the articles and each article is compared against the Chilean (economic) reference case, (iv) high-scored economic evaluations will be grouped according of their incremental cost-effectiveness ratio (ICER). If all ICERs do not converge, to the same conclusion, the intervention would not be transferable. If the ICERs of these studies converge, then the results will be compared against the national threshold. If the ICERs are greater than the threshold, the intervention would not be cost-effective. If the ICERs are lower than the threshold, then the intervention would be cost-effective in Chile.ConclusionsDespite a de novo analysis still being the gold standard to inform decision makers, the proposed instrument could be used as an alternative, given the short time limit and the scarcity of qualified human resources.

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The basics of economic evaluation in mental healthcare

BJPsych Advances ◽

10.1192/apt.bp.114.013003 ◽

2015 ◽

Vol 21 (5) ◽

pp. 345-353 ◽

Cited By ~ 3

Author(s):

James Shearer ◽

Sarah Byford

Keyword(s):

Economic Evaluation ◽

Cost Effectiveness ◽

Treatment Options ◽

Mental Healthcare ◽

Decision Makers ◽

Economic Evaluations ◽

Relative Cost ◽

Value For Money ◽

Relative Value ◽

Randomised Controlled

SummaryEconomic evaluation involves the comparative analysis of the costs and consequences of alternative (different) treatment options. Economic evaluations provide decision makers with information about the relative value for money, or cost-effectiveness, of various treatment programmes. The relative cost-effectiveness of new interventions is a key consideration in health technology assessments by the UK's National Institute for Health and Care Excellence, and economic evaluations alongside randomised controlled trials are routinely requested by funders such as the National Institute for Health Research. This article outlines some of the key concepts and issues in the economic evaluation of mental healthcare.

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Economic Evaluation of Long-Term Survivorship Care for Cancer Patients in OECD Countries: A Systematic Review for Decision-Makers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111558 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11558

Author(s):

David Brain ◽

Amarzaya Jadambaa

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Cancer Survivorship ◽

Decision Makers ◽

Economic Evaluations ◽

Economic Evidence ◽

Healthcare Decision ◽

Survivorship Care ◽

The Impact

Long-term cancer survivorship care is a crucial component of an efficient healthcare system. For numerous reasons, there has been an increase in the number of cancer survivors; therefore, healthcare decision-makers are tasked with balancing a finite budget with a strong demand for services. Decision-makers require clear and pragmatic interpretation of results to inform resource allocation decisions. For these reasons, the impact and importance of economic evidence are increasing. The aim of the current study was to conduct a systematic review of economic evaluations of long-term cancer survivorship care in Organization for Economic Co-operation and Development (OECD) member countries and to assess the usefulness of economic evidence for decision-makers. A systematic review of electronic databases, including MEDLINE, PubMed, PsycINFO and others, was conducted. The reporting quality of the included studies was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Each included study’s usefulness for decision-makers was assessed using an adapted version of a previously published approach. Overall, 3597 studies were screened, and of the 235 studies assessed for eligibility, 34 satisfied the pre-determined inclusion criteria. We found that the majority of the included studies had limited value for informing healthcare decision-making and conclude that this represents an ongoing issue in the field. We recommend that authors explicitly include a policy statement as part of their presentation of results.

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Looking forward and looking backward: Economic evaluations and regime support in China

Politics ◽

10.1177/0263395721989545 ◽

2021 ◽

pp. 026339572198954

Author(s):

Yida Zhai

Keyword(s):

Economic Evaluation ◽

National Economy ◽

Authoritarian Regimes ◽

Economic Situation ◽

Economic Conditions ◽

Economic Evaluations ◽

Age Cohorts ◽

Psychological Mechanism ◽

The Stability ◽

Regime Support

It is widely acknowledged that the economic situation is of vital importance for the stability of an authoritarian regime, but it is rarely known how the public’s economic evaluation contributes to such outcomes. This study examines the effects of citizens’ retrospective and prospective evaluations of their household economic situation and the national economy on the level of regime support in China. The findings show that the national economy outweighs household economic conditions in its effects on the public’s support of the regime. However, the gap between evaluations of the national economy and individual economic situations debilitates regime support. The population in different age cohorts has distinct patterns of relationships between retrospective and prospective economic evaluations and regime support. This study elucidates the political-psychological mechanism of the public’s economic evaluation affecting regime support, and the ruling strategy in authoritarian regimes of manipulating this evaluation.

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Economic Evaluation of RFID Technology in the Production Environment

International Journal of Engineering Business Management ◽

10.5772/56750 ◽

2013 ◽

Vol 5 ◽

pp. 39 ◽

Cited By ~ 2

Author(s):

Marcello Fera ◽

Raffaele Iannone ◽

Vincenzo Mancini ◽

Massimiliano M. Schiraldi ◽

Paolo Scotti

Keyword(s):

Economic Evaluation ◽

Pilot Project ◽

Evaluation Framework ◽

Added Value ◽

Economic Evaluations ◽

Rfid Technology ◽

Production Environment ◽

Management Level ◽

Traceability System ◽

Huge Impact

The aim of this paper is to present an economic evaluation framework of an RFID system implementation through a pilot project with the aim of streamlining logistic processes and compliance with higher level requirements. The company involved in the project belongs to the CPG (Consumer Packaged Goods) food industry, and in particular to the alimentary industry, whose principal scope was to comply the new norms of the sector by implementation of a better traceability system. This system, besides being very effective for the scope of the project, also had a huge impact in economic terms on logistics resources and cost reduction. For this reason, the discover of the RFID technology for the company has been greatly appreciated at management level, and today other fields of application are under evaluation. The added value of this article is contained not only in the results obtained in the economic evaluations, but also in the applied methodology, evidencing the advantages obtainable in the processes by cutting no added value operations. The economic analysis has thus been conducted on the basis of this TO-BE process streamlining.

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