Vaccines Don't Save Lives, Vaccination Does
Norman Begg in 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.
Economic evaluations of complex interventions
David A. Richards, Ingalill Rahm Hallberg in Complex Interventions in Health, 2015
Economics is a social science that aims to understand the production, distribution and consumption of any good or service and to generate information on how to achieve the most efficient use of scarce resources. Health economics has emerged as a sub-discipline in economics and involves the application of economics to health and health care. The existence of fixed health care budgets and finite health care resources means there is an opportunity cost for every decision made to provide any intervention. The decision to allocate resources to a particular service excludes those resources from alternative possible uses within a health care system. Hence complex interventions, like simple interventions, need to be assessed to understand whether they offer added value, in terms of the relative costs and benefits, compared to established best practice. Each complex intervention introduces its own particular set of challenges for the design and conduct of a robust economic evaluation. Two general challenges must always be addressed: (i) how to identify, collect resource use data for the intervention, subsequent treatments and pathways of care compared to current practice, and (ii) how to identify and quantify the impact of the intervention and current practice on the relevant patient population, which may sometimes include family members and carers.
Introduction
Vincent La Placa, Julia Morgan in Social Science Perspectives on Global Public Health, 2023
Traditionally, global public health has often been associated with the biomedical approach to medicine, with a focus upon, for instance, disease, the physical, and external observations of, for instance, illness, sanitation, and health services. Public health was rarely touched by social sciences and its rich plethora of perspective, theories, and capacity for insight. Where traditional public health did intertwine with the social sciences, it was often with the discipline of economics and the development of, for instance, health economics and the focus on supply, demand, and cost-effectiveness of public health interventions and the quantitative benefits, or otherwise, that their implementation generated. Even within health economics, traditional positivist approaches were adhered to, often overlooking, for instance, other socio-economic determinants, individual lifestyles and agency, and the broad social structures, generated through the direct or indirect organisation and patterning of societies.
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.
Preparing the Leaders of Tomorrow: Learnings from a Two-Year Community of Practice in Fragility Fractures
Published in Journal of European CME, 2022
Suzanne Murray, Bente Langdahl, Enrique Casado, Keyla Brooks, Cesar Libanati, Livio Di Lecce, Patrice Lazure
Leadership today involves a multitude of competencies. For example, a leader needs notions of behavioural science and educational psychology, as well as emotional intelligence (defined as the capacity to identify, understand, and manage complex emotions both in oneself and in others [14]), to be able to drive behaviour change in patients and colleagues [15,16]. The approach of using adult learning principles, which is both evidence-based and tailored to specific audiences, is essential in a peer-to-peer continuous learning environment [17]. Leading a team effectively involves developing interprofessional collaboration with colleagues to achieve optimal patient outcomes [18]. Knowledge of health economics has become essential for physicians to have a better understanding of the costs and benefits of health services and collaborating with healthcare administrators on their implementation [19]. Considering the growing reliance on technology in healthcare, technological literacy has become integral in the daily work of physicians [20]. Similarly, developing resilience in healthcare is key to reduce the rate of medical errors and burnouts, and hence, to maintain a high quality of care delivered to patients [21].
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