Tzeyu Michaud PhD Department of Health Promotion Social amp Behavioral Health UNMC Overview What is economic evaluations Why conduct economic evaluations Review of economic evaluations ID: 753523
Download Presentation The PPT/PDF document "Economic Evaluation in D & I Researc..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Economic Evaluation in D & I Research
Tzeyu Michaud, PhD
Department of Health Promotion, Social, & Behavioral Health
UNMCSlide2
Overview
What is economic evaluations?
Why conduct economic evaluations?
Review of economic evaluations
How to start an economic evaluation?
Return on Investment
Example
Q & A sessionSlide3
What is Economic Evaluations?
A tool to make comparisons of
alternative options
in terms of their costs and consequences
It provides a systematic way to identify, measure, value, and compare the costs and consequences of various programs, policies, or interventions
It is comparativeSlide4
Why conduct economic evaluations?
To inform the decisions of various health care systems about which health care interventions to fund from available resource
To evaluate whether an intervention are worth implementation and
To evaluate whether the benefits from already implemented interventions have been worth the costs
To ensure society can receive a good return on its investment in public healthSlide5
Healthcare Evaluation
Source: Drummond et al. Methods for the Economic Evaluation of Health Care Programmes, 2005.
No
Yes
No
Examine outcomes only
Examines costs only
cost-outcome description
outcome description
Cost description
YesEfficacy or effectiveness evaluationCost analysisFull economic evaluationCost-effectiveness analysisCost-benefit analysisCost-utility analysisCost-minimization analysis
Are both costs and outcomes measured?
Compare two or more alternatives?Slide6
Type of (full) Economic Evaluations
Method
Costs
Effects
Evaluation Question
Cost-effectiveness analysis
Monetary unit
Natural units (life-years gained, disease events prevented)
Comparison of intervention with same objectives
Cost-utility analysis
Monetary unitUtility, QALYs, or DALYsComparison of intervention with different objectivesCost-benefit analysisMonetary unitMonetary unitAre the benefits worth the costs?Cost-minimization analysisMonetary unitEffects are not measured (they are considered to be equal)Least-cost comparison of programs with the same outcomes
Adapted from WHO methodological approaches for CE and CUA of injury prevention measures, 2011.Slide7
How to Start an Economic Evaluation?Slide8
Intervention Costs
Fixed costs
Equipment/ technology
Facilities (e.g. office space, or intervention space)
Other
Variable costs
Personnel
Training
Administrative/ operating
Other (e.g. supplies)Slide9
Which costs are counted?
cost components/perspective
Societal
Healthcare sector
Payers
Formal healthcare
paid by payers
Yes
Yes
Yes
out-of-pocketYesYesNoInformal healthcare (e.g. transportation, unpaid caregiving time, or patient time)YesNoNoNon-healthcare (e.g. loss of productivityYes
NoNo
Adapted from Cost-Effectiveness in Health and Medicine, 2017.Slide10
Source of Cost Data Collection
Administrative data base
Survey for providers and beneficiaries
Observational studies
Expert panel
Published price list (e.g. average wholesale price)
Published literature
OthersSlide11
Return on Investment
Depends on what to include in gained and costs.
$ Gained (- $ Cost of Investment)
$ Costs of Investment
ROI =Slide12
Weight and Win: a 12-month community weight loss program
Implementation costs- 2.82 millions
Program evaluation
Reach: 33,656 person who were overweight or obese (African American were over-represented)
Effectiveness :
47%
and
34%
of participants loss 3% and 5% of initial body weight, respectively
Cost per clinically meaningful weight loss for African Americans ($258/ 3%loss; $336/5%loss) was lower than that for Hispanics ($319; $431) and Caucasians($314; $442)Slide13
A state transition Markov model to project lifetime economic outcome and the degree of disease averted, compared with no intervention
The program was predicted to avert (with a corresponding estimated medical costs saved of)
78 cases of coronary heart disease ($28 million)
9 cases of strokes ($971,832)
92 cases of diabetes ($24 million)
3 cases of breast cancer ($483,259)
1 case of colorectal cancer ($357,022)
The estimated medical costs saved per participant was $
1,403
($
1,077 of African American men and $1,532 of Hispanic men), and the ROI was $16.7 ($12.8 for African American men and $18.3 for Hispanic men)Slide14
Cost-Effectiveness AnalysisSlide15
Cost ComponentsSlide16
Summary
Economic evaluation is comparative
Plan ahead (cost data, alternative comparison, perspective, outcomes measured)
ASK for help!Slide17
Resource
Cost-Effectiveness in Health and Medicine, Gold et al., 1996
Methods for the Economic Evaluation of Health Care Programmes, Drummond et al., 2015
Guidelines for reporting economic evaluations for health interventions.
http://www.equator-network.org/wp-content/uploads/2013/04/Revised-CHEERS-Checklist-Oct13.pdf
Tufts CEA registry.
http://healtheconomics.tuftsmedicalcenter.org/cear4/SearchingtheCEARegistry/SearchtheCEARegistry.aspxSlide18
Thank You
tzeyu.michaud@unmc.eduSlide19
Reported OutcomesSlide20
Cost-Effectiveness Analysis
Relevant when alternative options have different costs and health consequences
Costs are valued in monetary terms (e.g., US$)
Benefits are valued in terms of clinical outcomes (e.g., cases prevented or cured, lives saved, years of life gained, quality-adjusted life years gained)
Results reported as a cost-effectiveness ratioSlide21
Cost-Effectiveness Ratio
Net increase in health care costs
Net gain in
health effects
quality-adjusted life years
cost-utility analysisSlide22
Example 1Slide23
Example 3