scholarly journals Understanding Economic Evaluation: A Policy Perspective for Clinicians

1997 ◽  
Vol 4 (4) ◽  
pp. 190-199
Author(s):  
M Giacomini ◽  
J Hurley
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Policy Making ◽  
Evaluation Studies ◽  
Evaluation Research ◽  
Critical Evaluation ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Current Debate ◽  
Research Information

The rhetoric of ‘efficiency’ frames much current debate about how limited health care resources should be used. Clinicians increasingly turn to economic evaluation literature to discern evidence-based claims of ‘efficiency’ or ‘cost effectiveness’ from empty ones. Economic evaluation research is designed to compare health services on the basis of their efficiency (eg, how well they produce health benefits relative to resource costs). Although economic studies appear throughout the respirology literature, relatively few are complete economic evaluations. Economic evaluation studies serve various purposes, including critical evaluation and persuasive marketing, which produce studies that vary in research agendas and scientific rigour. This paper is intended to serve clinicians and consumers of economic evaluation studies by: introducing economic evaluation research information as a policy making tool; describing the three basic elements and three basic types of economic evaluation (cost-benefit, cost-effectiveness, and cost-utility analyses); and reviewing some limitations of economic evaluation information for policy decision making. The usefulness of economic evaluation research for policy making depends not only on the scientific merit of the analysis but also crucially on whose specific concerns the research questions address.

scholarly journals A Systematic Review of Methods, Study Quality, and Results of Economic Evaluation for Childhood and Adolescent Obesity Intervention

2019 ◽  
Vol 16 (3) ◽  
pp. 485 ◽  
Author(s):  
Mandana Zanganeh ◽  
Peymane Adab ◽  
Bai Li ◽  
Emma Frew
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Evidence Synthesis ◽  
Evaluation Studies ◽  
Cost Effective ◽  
Adolescent Obesity ◽  
Economic Evaluations ◽  
Full Economic Evaluation ◽  
Childhood And Adolescent Obesity

Many suggested policy interventions for childhood and adolescent obesity have costs and effects that fall outside the health care sector. These cross-sectorial costs and consequences have implications for how economic evaluation is applied and although previous systematic reviews have provided a summary of cost-effectiveness, very few have conducted a review of methods applied. We undertook this comprehensive review of economic evaluations, appraising the methods used, assessing the quality of the economic evaluations, and summarising cost-effectiveness. Nine electronic databases were searched for full-economic evaluation studies published between January 2001 and April 2017 with no language or country restrictions. 39 economic evaluation studies were reviewed and quality assessed. Almost all the studies were from Western countries and methods were found to vary by country, setting and type of intervention. The majority, particularly “behavioural and policy” preventive interventions, were cost-effective, even cost-saving. Only four interventions were not cost effective. This systematic review suggests that economic evaluation of obesity interventions is an expanding area of research. However, methodological heterogeneity makes evidence synthesis challenging. Whilst upstream interventions show promise, an expanded and consistent approach to evaluate cost-effectiveness is needed to capture health and non-health costs and consequences.

scholarly journals The Cost-Effectiveness of Mobile Health (mHealth) Interventions for Older Adults: Systematic Review

2020 ◽  
Vol 17 (15) ◽  
pp. 5290
Author(s):  
Zartashia Ghani ◽  
Johan Jarl ◽  
Johan Sanmartin Berglund ◽  
Martin Andersson ◽  
Peter Anderberg
Keyword(s):  
Older Adults ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Empirical Evidence ◽  
Mobile Health ◽  
Evaluation Studies ◽  
Health Economic Evaluation ◽  
Reporting Quality ◽  
Economic Evaluations ◽  
The Cost

The objective of this study was to critically assess and review empirical evidence on the cost-effectiveness of Mobile Health (mHealth) interventions for older adults. We systematically searched databases such as Pubmed, Scopus, and Cumulative Index of Nursing and Allied Literature (CINAHL) for peer-reviewed economic evaluations published in English from 2007 to 2018. We extracted data on methods and empirical evidence (costs, effects, incremental cost-effectiveness ratio) and assessed if this evidence supported the reported findings in terms of cost-effectiveness. The consolidated health economic evaluation reporting standards (CHEERS) checklist was used to assess the reporting quality of the included studies. Eleven studies were identified and categorized into two groups: complex smartphone communication and simple text-based communication. Substantial heterogeneity among the studies in terms of methodological approaches and types of intervention was observed. The cost-effectiveness of complex smartphone communication interventions cannot be judged due to lack of information. Limited evidence of cost-effectiveness was found for interventions related to simple text-based communications. Comprehensive economic evaluation studies are warranted to assess the cost-effectiveness of mHealth interventions designed for older adults.

scholarly journals The potential of economic evaluation studies to improve health screening and assessment policies for asylum seekers in Germany

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Biddle ◽  
K Wahedi ◽  
K Bozorgmehr
Keyword(s):  
Economic Evaluation ◽  
Asylum Seekers ◽  
Evaluation Studies ◽  
Scientific Evidence ◽  
Research Process ◽  
Health Screening ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Targeted Screening ◽  
Modelling Studies

Abstract This presentation will discuss the potential for conducting economic evaluation studies in the field of migration and health, by focusing on health screening and assessment for newly arriving asylum seekers. We use three economic case studies from Germany to illustrate this potential, reflecting on the benefits of an economic approach, the contribution of modelling studies, the quality and reliability of the underlying data sources and other lessons learnt in the research process. Screening for illness among newly arriving individuals has the potential to expand access to essential services and overcome access barriers, thus improving efficiency by preventing costs of late presentations. This is demonstrated by a recent modelling study on the cost-utility of screening for depression. However, an overview of different screening policies in Germany shows that unnecessary procedures which are not supported by sound scientific evidence may lead to inefficiencies in excess of €3.1 million, which could be more effectively invested in other parts of the health system. Finally, efficiency gains could be made by assessing who benefits most from screening, and designing targeted screening approaches for these groups, as in the case of targeted screening for active tuberculosis by country of origin. We will end the presentation by reflecting on the potential role for economic evaluations health policy-making, and the challenges of communicating and translating the nuances of economic evidence into practice.

scholarly journals Neuropsychological rehabilitation interventions for people with an acquired brain injury and their caregivers. A protocol for a systematic review of economic evaluation

2020 ◽  
Vol 3 ◽  
pp. 83
Author(s):  
Eileen Mitchell ◽  
Elayne Ahern ◽  
Sanjib Saha ◽  
Dominic Trepel
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Brain Injury ◽  
Evaluation Studies ◽  
Cost Benefit ◽  
Acquired Brain Injury ◽  
Current Evidence ◽  
Economic Evaluations ◽  
Systematic Review Methodology

Background: New emerging evidence has demonstrated the need for effective interventions to help people living with an acquired brain injury (ABI). Evidence on cost-effectiveness, which can help inform use of limited resources, is scarce in this area and therefore the purpose of this systematic review is to critically appraise and consolidate the current evidence on economic evaluations of ABI rehabilitation interventions. Methods: Systematic review methodology will be applied to identify, select and extract data from published economic evaluation studies (trial-based, non-trial based, simulation-based, decision model and trial-based model economic evaluations) of ABI treatment interventions in adults. A systematic literature search will be conducted on the following electronic databases: EMBASE, Econlit, CINAHL, Medline, Econlit, the National Health Service Economic Evaluation Database and PsyclNFO. This review will only include cost-effectiveness analysis studies (e.g., cost per life year gained), cost-benefit and cost minimisation analyses in which the designs were randomised controlled trials (RCTs), non-RCT studies, cost-utility analyses (e.g., cost per quality-adjusted life year (QALY) gained or cost per disability-adjusted life year averted), cohort studies, and modeling studies. Only studies that were published in English, associated with adults who have an ABI will be included. There will be no restrictions on perspective, sample size, country, follow-up duration or setting. The search strategy terms will include the following: acquired brain injury, brain*; cost*; or cost–benefit analysis*. Following data extraction, a narrative summary and tables will be used to summarize the characteristics and results of included studies. Discussion: The findings from this review will be beneficial to health policy decision makers when examining the evidence of economic evaluations in this field. In addition, it is anticipated that this review will identify gaps in the current economic literature to inform future-related research. Systematic review registration: PROSPERO CRD42020187469 (25th June 2020).

scholarly journals Economic evaluation studies in the field of HIV/AIDS: bibliometric analysis on research development and scopes (GAPRESEARCH)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bach Xuan Tran ◽  
Long Hoang Nguyen ◽  
Hugo C. Turner ◽  
Son Nghiem ◽  
Giang Thu Vu ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Latent Dirichlet Allocation ◽  
Evaluation Studies ◽  
Similarity Index ◽  
Cost Benefit ◽  
Cost Utility ◽  
Future Research ◽  
Economic Evaluations ◽  
Research Topics ◽  
Hiv Aids

Abstract Background The rapid decrease in international funding for HIV/AIDS has been challenging for many nations to effectively mobilize and allocate their limited resources for HIV/AIDS programs. Economic evaluations can help inform decisions and strategic planning. This study aims to examine the trends and patterns in economic evaluation studies in the field of HIV/AIDS and determine their research landscapes. Methods Using the Web of Science databases, we synthesized the number of papers and citations on HIV/AIDS and economic evaluation from 1990 to 2017. Collaborations between authors and countries, networks of keywords and research topics were visualized using frequency of co-occurrence and Jaccards’ similarity index. A Latent Dirichlet Allocation (LDA) analysis to categorize papers into different topics/themes. Results A total of 372 economic evaluation papers were selected, including 351 cost-effectiveness analyses (CEA), 11 cost-utility analyses (CUA), 12 cost-benefit analyses (CBA). The growth of publications, their citations and usages have increased remarkably over the years. Major research topics in economic evaluation studies consisted of antiretroviral therapy (ART) initiation and treatment; drug use prevention interventions and prevention of mother-to-child transmission interventions. Moreover, lack of contextualized evidence was found in specific settings with high burden HIV epidemics, as well as emerging most-at-risk populations such as trans-genders or migrants. Conclusion This study highlights the knowledge and geographical discrepancies in HIV/AIDS economic evaluation literature. Future research directions are also informed for advancing economic evaluation in HIV/AIDS research.

scholarly journals Economic Evaluation of Severe Anaemia: Review-Based Recommendations and a Conceptual Framework

2020 ◽  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Blood Cell ◽  
Conceptual Framework ◽  
Red Blood Cell ◽  
Budget Impact ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Economic Analyses ◽  
Impact Models

Objective: Novel anaemia treatments have greatly improved patient outcomes in the last decade and have also undergone economic evaluations in various settings using heterogenous model structures, costs, and inputs. The objectives were to review published economic evaluation studies in major red blood cell disorders, identify limitations in the applied methodology, provide a set of recommendations, and produce a conceptual framework for future economic research in this disease area. Methods: A targeted search was conducted for economic literature evaluating treatments in major red blood cell disorders related to anaemia. Disorders included autoimmune haemolytic anaemia, β-thalassaemia, chemotherapy-induced anaemia, anaemia in chronic kidney disease, and severe aplastic anaemia. Budget impact models and cost-effectiveness and cost-utility analyses were considered. Modelling assumptions regarding the model structure, time horizon, perspective, and type of costs were reviewed and recommendations and a conceptual framework for future economic analyses were created. Results: A total of four budget impact models, nine cost-utility analyses, and four cost-effectiveness analyses were investigated. A major limitation was that the included costs varied significantly across studies. Costs which were rarely included, and generally should be considered, were related to adverse events, mortality, and productivity. Additionally, relationships between levels of serum ferritin, hepatic or total body iron, and haemoglobin with long-term complications and mortality were rarely included. Conclusion: Published economic analyses evaluating treatments for major red blood cell disorders frequently exclude vital costs. A set of recommendations and a conceptual framework will aid researchers in applying a more comprehensive approach for economic evaluations in major red blood cell disorders.

Economic evaluations of videoconference and telephone consultations in primary care: A systematic review

2021 ◽  
pp. 1357633X2110433
Author(s):  
Keshia R De Guzman ◽  
Centaine L Snoswell ◽  
Liam J Caffery ◽  
Anthony C Smith
Keyword(s):  
Primary Care ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Cost Minimization ◽  
Health Economic Evaluation ◽  
Reporting Quality ◽  
Cost Effective ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Published Evidence

Introduction Telehealth services using videoconference and telephone modalities have been increasing exponentially in primary care since the coronavirus pandemic. The challenge now is ensuring that these services remain sustainable. This review investigates the cost-effectiveness of videoconference and telephone consultations in primary care settings, by summarizing the available published evidence. Methods A systematic search of PubMed, Embase, Scopus, and CINAHL databases was used to identify articles published from January 2000 to July 2020, using keyword synonyms for telehealth, primary care, and economic evaluation. Databases were searched, and title, abstract, and full-text reviews were conducted. Article reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. Results Twenty articles were selected for inclusion, with 12 describing telephone triage services, seven describing telehealth substitution services, and one describing another telehealth service in primary care. These services were delivered by nurses, doctors, and allied health clinicians. Of the 20 included studies, 11 used cost analyses, five used cost-minimization analyses, and four used one or more methods, including either a cost–consequence analysis, a cost–utility analysis, or a cost-effectiveness analysis. Conclusions Telephone and videoconference consultations in primary care were cost-effective to the health system when deemed clinically appropriate, clinician when time was used efficiently, and when overall demand on health services was reduced. The societal benefits of telehealth consultations should be considered an important part of telehealth planning and should influence funding reform decisions for telehealth services in primary care.

scholarly journals Cost-effectiveness of prehabilitation prior to elective surgery compared to usual preoperative care: protocol for a systematic review of economic evaluations

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040262
Author(s):  
Tanja Rombey ◽  
Helene Eckhardt ◽  
Wilm Quentin
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Functional Capacity ◽  
Elective Surgery ◽  
Cost Utility ◽  
Preoperative Care ◽  
Postoperative Outcomes ◽  
Economic Evaluations ◽  
Care Protocol

IntroductionPreoperative functional capacity is an important predictor of postoperative outcomes. Prehabilitation aims to optimise patients’ functional capacity before surgery to improve postoperative outcomes. As prolonged hospital stay and postoperative complications present an avoidable use of healthcare resources, prehabilitation might also save costs.The aim of this systematic review is to investigate the cost-effectiveness of prehabilitation programmes for patients awaiting elective surgery compared with usual preoperative care. The results will be useful to inform decisions about the implementation of prehabilitation programmes and the design of future economic evaluations of prehabilitation programmes.Methods and analysisWe will search PubMed, Embase, the Centre for Reviews and Dissemination Database, the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov for full or partial economic evaluations of preoperative prehabilitation programmes conducted in any population compared with usual preoperative care. Studies will be included regardless of the type, design and perspective of the economic evaluation, and their publication year, language or status. Initial searches were performed between 30 April and 4 May 2020.Study selection, data extraction and assessment of the included studies’ risk of bias and methodological quality will initially be performed by two independent reviewers and, if agreement was sufficiently high, by one reviewer. We will extract data regarding the included studies’ basic characteristics, economic evaluation methods and cost-effectiveness results.A narrative synthesis will be performed. The primary endpoint will be cost-effectiveness based on cost–utility analyses. We will discuss heterogeneity between the studies and assess the risk of publication bias. The certainty of the evidence will be determined using the Grading of Recommendations, Assessment, Development and Evaluation approach.Ethics and disseminationEthics approval is not required as the systematic review will not involve human participants. We plan to present our findings at scientific conferences, pass them on to relevant stakeholder organisations and publish them in a peer-reviewed journal.PROSPERO registration numberCRD42020182813

scholarly journals Economic evaluation of cognitive behavioural therapy for insomnia (CBT-I) for improving health outcomes in adult population: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032176 ◽  
Author(s):  
Andrea Natalie Natsky ◽  
Andrew Vakulin ◽  
Ching Li Chai-Coetzer ◽  
Leon Lack ◽  
R. Doug McEvoy ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Adult Population ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Primary Data ◽  
Economic Evaluations ◽  
Cost Minimisation Analysis ◽  
Cognitive Behavioural

IntroductionInsomnia is associated with a number of adverse consequences that place a substantial economic burden on individuals and society. Cognitive behavioural therapy for insomnia (CBT-I) is a promising intervention that can improve outcomes in people who suffer from insomnia. However, evidence of its cost-effectiveness remains unclear. In this study, we will systematically review studies that report on economic evaluations of CBT-I and investigate the potential economic benefit of CBT-I as a treatment for insomnia.Methods and analysisThe search will include studies that use full economic evaluation methods (ie, cost-effectiveness, cost-utility, cost-benefit, cost-consequences and cost-minimisation analysis) and those that apply partial economic evaluation approaches (ie, cost description, cost-outcome description and cost analysis). We will conduct a preliminary search in MEDLINE, Google Scholar, MedNar and ProQuest dissertation and theses to build the searching terms. A full search strategy using all identified keywords and index terms will then be undertaken in several databases including MEDLINE, Psychinfo, Proquest, Cochrane, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science and EMBASE. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for protocol guidelines in this review. Only articles in the English language and those reporting on adult populations will be included. We will use standardised data extraction tools for economic evaluations to retrieve and synthesise information from selected studies into themes and summarised in a Joanna Briggs Institute dominance ranking matrix.Ethics and disseminationNo formal ethics approval will be required as we will not be collecting primary data. Review findings will be disseminated through a peer-reviewed publication, workshops, conference presentations and a media release.PROSPERO registration numberCRD42019133554.

scholarly journals Cost-effectiveness analysis for priority setting in health: Penny-wise but pound-foolish

2005 ◽  
Vol 21 (4) ◽  
pp. 532-534 ◽  
Author(s):  
Rob Baltussen ◽  
Werner Brouwer ◽  
Louis Niessen
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Priority Setting ◽  
Evaluation Studies ◽  
Evaluation Research ◽  
National Policy ◽  
Cost Effectiveness Analysis ◽  
Full Potential ◽  
Policy Makers ◽  
Effectiveness Analysis

Cost-effectiveness analysis has much conceptual attractiveness in priority setting but is not used to its full potential to assist policy-makers on making choices in health in developed or in developing countries. We call for a shift away from present economic evaluation activities—that tend to produce ad hoc and incomparable economic evaluation studies and, therefore, add little to the compendium of knowledge of cost-effectiveness of health interventions in general—toward a more systematic approach. Research efforts in economic evaluation should build on the foundations of cost-effectiveness research of the past decades to arrive at an informative methodology useful for national policy-makers. This strategy means that governments should steer sectoral cost-effectiveness analysis to obtain systematic and comprehensive information on the economic attractiveness of a set of new and current interventions, using a standardized methodology and capturing interactions between interventions. Without redirecting the focus of economic evaluation research, choosing in health care bears the risk to remain penny-wise but pound-foolish.

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