Methods for the Economic Evaluation of Health Care Programmes

by Drummond, Michael F.; O'Brien, Bernard J.; Stoddart, Greg L.; Torrance, George W.

• ISBN13: 9780192627735
• ISBN10: 0192627732
• Edition: 2nd
• Format: Paperback
• Copyright: 1997-09-25
• Publisher: Oxford University Press

Summary

Since its publication in 1987, Methods for the economic evaluation of health care programmes has become the standard textbook in this field world-wide. Over the past ten years, the field of economic evaluation in health care has expanded considerably, with a rapid rise in the number of published studies, and wider recognition of their use in health care decision-making. Developments in economic evaluation have also led to the publication of several guidelines for study methodology, most recently those proposed by the United States Public Health Services Panel. The new edition of Methods for the economic evaluation of health care programmes follows the same basic structure as the first edition. The key methodological principles are outlined using a critical appraisal checklist that can be applied to any published study. The methodological features of the basic forms of analysis (cost analysis, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis) are then explained in more detail. The book has been greatly revised and enlarged, especially with respect to cost-utility and cost- benefit analysis, where major methodological developments have taken place. New to this edition are chapters on collecting and analysing data, and presenting and using economic evaluation results. The new edition will be required reading for anyone commissioning, undertaking, or using economic evaluations in health care, and will be popular with health service professionals, health economists, and health-care decision makers. Reviews of the first edition: 'An important contribution to studies on the economic evaluation of medical care...' (British Medical Journal) 'This is essential reading. Only if all managers are aware of the powers of economic techniques will they be used sensibly' (The Health Service Journal (UK) 'The methodological chapters on cost analysis and cost utility analysis are gems... should become the standard text on the subject at the intermediate level at which it is aimed.' (Medical Decision Making) 'It leaves nothing important in economic evaluation analysis untouched.' (Health Policy and Planning)

Table of Contents

Preface to the first edition	v
Acknowledgements	vi
Preface to the second edition	vii
How to use this book	1	(5)
Basic types of economic evaluation	6	(21)
Why is economic evaluation important?	7	(1)
What does economic evaluation mean?	8	(3)
Do all economic evaluations use the same techniques?	11	(6)
What are the relevant costs and consequences in the economic evaluation of health care programmes?	17	(10)
Critical assessment of economic evaluation	27	(25)
Elements of a sound economic evaluation	29	(15)
Limitations of economic evaluation techniques	44	(1)
Conclusions	45	(1)
Critical appraisal of a published article	45	(7)
Cost analysis	52	(44)
Some basics	52	(16)
Allowance for differential timing of costs (discounting and the annuitization of capital expenditures)	68	(6)
Allocation of overhead costs: example	74	(7)
Exercise: costing alternative radiotherapy treatments	81	(15)
Annex 4.1. Tutorial on methods of measuring and valuing capital costs	88	(4)
Annex 4.2. Discount Tables	92	(4)
Cost-effectiveness analysis	96	(43)
Some basics	96	(16)
Exercise: designing a cost-effectiveness study	112	(12)
Critical appraisal of a published article	124	(4)
Use of quality-of-life scales in economic evaluation	128	(3)
Interpreting incremental cost-effectiveness ratios	131	(8)
Cost-utility analysis	139	(66)
Some basics	139	(4)
Utilities	143	(7)
Measuring preferences	150	(7)
Multi-attribute health status classification systems with preference scores	157	(8)
Quality-adjusted life-years (QALYs)	165	(18)
Advanced topics	183	(2)
Critical appraisal of a published article	185	(20)
Annex 6.1. Simulated interview	199	(6)
Cost-benefit analysis	205	(27)
Some basics	205	(3)
Assigning money values to health outcomes	208	(9)
What might we mean by willingness-to-pay?	217	(5)
Pragmatic measurement issues	222	(3)
Conclusions	225	(1)
Exercise: designing a contingent valuation survey for a new treatment for ovarian cancer	225	(7)
Collection and analysis of data	232	(33)
Introduction	232	(3)
Economic evaluation and clinical trials	235	(7)
Modelling studies: approaches and issues	242	(5)
Analysis plans for economic evaluation	247	(1)
Statistical analysis and economic evaluation	248	(8)
Research agenda	256	(1)
Conclusions	257	(1)
Exercise: economic evaluation alongside clinical trials - a case study in osteoporosis	258	(7)
Presentation and use of economic evaluation results	265	(28)
Introduction	265	(1)
Reporting formats for economic evaluation	266	(2)
Interpreting cost-effectiveness `league tables'	268	(4)
Transferring economic evaluation results from setting to setting	272	(12)
Problems and potential for using economic evaluation in decision-making	284	(6)
Conclusions	290	(3)
How to take matters further	293	(4)
Economic evaluator's survival guide	293	(2)
Additional literature	295	(2)
Author index	297	(2)
Subject index	299