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Vaccines Don't Save Lives, Vaccination Does
Published in Norman Begg, The Remarkable Story of Vaccines, 2023
Health economics is also important. No country has a limitless health budget, so when a new vaccine comes along, the government must decide whether or not to prioritise it. This is a poisoned chalice. It’s easy enough to work out the cost of a vaccination programme, but what price do you put on someone who dies, or has a lifelong disability because they didn’t get vaccinated? Health economists try to take this into account by measuring quality of life, the duration of illness and disability, health service utilisation and so on, but inevitably there is an element of subjectivity. If you just take the healthcare costs into account, the return on investment doesn’t look nearly as good as if you include the wider costs. For example, when a child gets chickenpox, they will be off school for a week or two, so one of the parents has to stay at home, which impacts their economic productivity. The child will then give it to their siblings, so the cycle is repeated. Most of the economic benefit of chickenpox vaccination is preventing these indirect costs. Luckily, most vaccines are relatively inexpensive, so health economic analyses are usually positive. Wealthier countries will usually adopt a new vaccine sooner or later, but it can take many years for some vaccines to get into the national vaccination calendar. In the UK, the only vaccine that has not yet been recommended for all children is chickenpox. On the other hand, the UK was the first country in the world to recommend meningitis vaccine for all babies; this is because the UK had one of the highest rates of disease in the developed world.
Economics and Global Health
Published in Vincent La Placa, Julia Morgan, Social Science Perspectives on Global Public Health, 2023
Julia Ngozi Chukwuma, Kevin Deane
Economics primarily appears in global health programmes in the guise of Health Economics. Broadly speaking, Health Economics involves two distinct strands. One strand focuses on the application of core neoclassical economic theories of the firm, the consumer, and the market to health-behaviour, and other health issues. It suggests a role for government intervention, only in the case of specific market failures (for example externalities, asymmetric information, moral hazard, and public goods) that distort market outcomes. Health Economics also promotes economic evaluation techniques that are used to assess the cost-effectiveness of competing interventions. However, what is rarely made clear to global public health students is that Health Economics, as a subfield of economics, applies only one version of economics (neoclassical economics), to health.
Economic Analysis and Outcome Assessment
Published in Kelly H. Zou, Lobna A. Salem, Amrit Ray, Real-World Evidence in a Patient-Centric Digital Era, 2023
Jean-Pascal Roussy, Kelly H. Zou
During the last decades, the emergence of HTA authorities and the increasing reliance on economic evaluations to inform healthcare decisions have forced the field of health economics to constantly refine its standards and methodological approaches. We provided above an overview of the categories of economic evaluations and context for their use, but important methodological aspects related to conducting such analyses were not presented. This includes topics such as the choice of comparators, study perspective, analytical approaches (trial-based evaluation vs. economic model), valuing and measuring cost, benefits, and patient preferences (utility), and testing for the robustness of the results (sensitivity analyses). Specialized references (Drummond et al., 2015; Sanders et al., 2016) are available to guide the analysts in the conduct, reporting, and appraisal of the economic analyses.
The economic evaluation of ALS care: quality and cost
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2023
Mustafa Çoban, Uğur Bilge, Hale Balseven, Hilmi Uysal, Betül Artut
The aging population and increased patient demand for healthcare services, technologies, and drugs, all contribute to the continuing increase in healthcare expenditures. Health economics studies provide information to decision makers for efficient use of resources for maximizing health benefits. Economic evaluation is one aspect of health economics, and it is a tool for comparing costs and consequences of different interventions (1). According to the Committee on the Quality of Health Care in America that was formed in June 1998, care must be delivered by systems that are carefully and consciously designed to provide care that is safe, effective, patient-centred, timely, efficient, and equitable (Institute of Medicine, 2001). Research on the quality of care reveals that health care systems frequently fall short in their ability to translate knowledge into practice, and apply new technology safely and appropriately. During the last decade alone, more than 70 publications in leading peer-reviewed journals have documented serious shortcomings in quality (2).
Number needed to treat analysis applied to pembrolizumab plus chemotherapy for first-line treatment of non-squamous non-small cell lung cancer
Published in Journal of Medical Economics, 2021
Luciano Paladini, Cássia Rita Pereira da Veiga, Érica Cerqueira, Laura Chabrol Haas, Márcia Datz Abadi, Clarissa Seródio Baldotto
In light of the unequivocal clinical benefits of immunotherapy for NSCLC, strategies weighing the economic impact for decision-making are necessary9 as healthcare systems are facing the need to ensure timely access to new technologies that satisfy patients’ unmet needs while managing the economic impact and health system sustainability10. Several methodologies have already been proposed for new health technologies’ economic assessment; however, some strategies comprise complex mathematical models that healthcare professionals and decision-makers unfamiliar with health economics studies might find difficult to understand11. In addition, the results depend on the particularities of different countries’ healthcare systems12–15, and the incorporation of PD-L1 expression in the analysis may alter the cost-effectiveness and potential years of life gained due to this new technology16,17.
Health technology assessment in Japan: a work in progress
Published in Journal of Medical Economics, 2020
Isao Kamae, Rob Thwaites, Anna Hamada, Jovelle L. Fernandez
The cost-effectiveness evaluation is to be conducted in accordance with a methodological guideline (version 2) that was approved by Chuikyo's Cost-Effectiveness Assessment Committee, which comprises representatives from healthcare insurers, healthcare professionals, members of the public, and nonvoting members from industry and nonvoting members with health economics expertise13. The guideline was first published in 20168 and has been revised to take account of the findings from the pilot HTA program14. In the current version, it has been clarified that evaluations are to be conducted from the perspective of the national health insurance system, and the selection of an appropriate comparator for the evaluation (an existing comparator drug on the market) is to be agreed in advance with the manufacturer.