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Appropriate Perspectives for Health Care Decisions

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Author Info

  • Karl Claxton

    (Centre for Health Economics, University of York, UK and Department of Economics and Related Studies, University of York, UK)

  • Simon Walker

    (Centre for Health Economics, University of York, UK)

  • Steven Palmer

    (Centre for Health Economics, University of York, UK)

  • Mark Sculpher

    (Centre for Health Economics, University of York, UK)

Abstract

NICE uses cost-effectiveness analysis to compare the health benefits expected to be gained by using a technology with the health that is likely to be forgone due to additional costs falling on the health care budget and displacing other activities that improve health. This approach to informing decisions will be appropriate if the social objective is to improve health, the measure of health is adequate and the budget for health care can reasonably be regarded as fixed. If NICE were to recommend a broader =societal perspective‘, wider effects impacting on other areas of the public sector and the wider economy would be formally incorporated into analyses and decisions. The problem for policy is that, in the face of budgets legitimately set by government, it is not clear how or whether a societal perspective can be implemented, particularly if transfers between sectors are not possible. It poses the question of how the trade-offs between health, consumption and other social arguments, as well as the valuation of market and non market activities, ought to be undertaken.

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File URL: http://www.york.ac.uk/media/che/documents/papers/researchpapers/rp54_appropriate_perspectives_for_health_care_decisions.pdf
File Function: First version, 2010
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Bibliographic Info

Paper provided by Centre for Health Economics, University of York in its series Working Papers with number 054cherp.

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Length: 86 pages
Date of creation: Jan 2010
Date of revision:
Handle: RePEc:chy:respap:54cherp

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Related research

Keywords: Perspective. Cost-effectiveness analysis. Economic evaluation.;

This paper has been announced in the following NEP Reports:

References

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  1. Xavier Sala-I-Martin & Gernot Doppelhofer & Ronald I. Miller, 2004. "Determinants of Long-Term Growth: A Bayesian Averaging of Classical Estimates (BACE) Approach," American Economic Review, American Economic Association, vol. 94(4), pages 813-835, September.
  2. Martin, Stephen & Rice, Nigel & Smith, Peter C., 2008. "Does health care spending improve health outcomes? Evidence from English programme budgeting data," Journal of Health Economics, Elsevier, vol. 27(4), pages 826-842, July.
  3. Karl Claxton & Mark Sculpher & Tony Culyer, 2007. "Mark versus Luke? Appropriate Methods for the Evaluation of Public Health Interventions," Working Papers 031cherp, Centre for Health Economics, University of York.
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  5. Kobelt, Gisela & Lindgren, Peter & Parkin, David & Francis, David A. & Johnson, Michael & Bates, David & Jönsson, Bengt, 2000. "Costs and Quality of Life in Multiple Sclerosis. A Cross-Sectional Observational Study in the UK," Working Paper Series in Economics and Finance 398, Stockholm School of Economics.
  6. Meltzer, David, 1997. "Accounting for future costs in medical cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 33-64, February.
  7. Birch, Stephen & Gafni, Amiram, 1992. "Cost effectiveness/utility analyses : Do current decision rules lead us to where we want to be?," Journal of Health Economics, Elsevier, vol. 11(3), pages 279-296, October.
  8. Appleby, John & Devlin, Nancy & Parkin, David & Buxton, Martin & Chalkidou, Kalipso, 2009. "Searching for cost effectiveness thresholds in the NHS," Health Policy, Elsevier, vol. 91(3), pages 239-245, August.
  9. David E. Bloom & David Canning & Jaypee Sevilla, 2001. "The Effect of Health on Economic Growth: Theory and Evidence," NBER Working Papers 8587, National Bureau of Economic Research, Inc.
  10. Garber, Alan M. & Phelps, Charles E., 1997. "Economic foundations of cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 1-31, February.
  11. Brouwer, Werner B.F. & Culyer, Anthony J. & van Exel, N. Job A. & Rutten, Frans F.H., 2008. "Welfarism vs. extra-welfarism," Journal of Health Economics, Elsevier, vol. 27(2), pages 325-338, March.
  12. McCabe, C & Claxton, K & Culyer, AJ, 2008. "The NICE Cost-Effectiveness Threshold: What it is and What that Means," MPRA Paper 26466, University Library of Munich, Germany.
  13. Mike Paulden & Karl Claxton, 2009. "Budget allocation and the revealed social rate of time preference for health," Working Papers 053cherp, Centre for Health Economics, University of York.
  14. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis," NBER Technical Working Papers 0227, National Bureau of Economic Research, Inc.
  15. Karl Claxton & Mike Paulden & Hugh Gravelle & Werner Brouwer & Anthony J. Culyer, 2011. "Discounting and decision making in the economic evaluation of health‐care technologies," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 2-15, January.
  16. Werner B. F. Brouwer & Marc A. Koopmanschap & Frans F. H. Rutten, 1997. "Productivity Costs Measurement Through Quality of Life? A Response to the Recommendation of the Washington Panel," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 253-259.
  17. Johannesson, Magnus & Weinstein, Milton C., 1993. "On the decision rules of cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 12(4), pages 459-467, December.
  18. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
  19. Johannesson, Magnus & O'Conor, Richard M., 1997. "Cost-utility analysis from a societal perspective," Health Policy, Elsevier, vol. 39(3), pages 241-253, March.
  20. Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118 Elsevier.
  21. Johannesson, Magnus, 1995. "The relationship between cost-effectiveness analysis and cost-benefit analysis," Social Science & Medicine, Elsevier, vol. 41(4), pages 483-489, August.
  22. Werner B.F. Brouwer & Marc A. Koopmanschap & Frans F.H. Rutten, 1997. "Productivity costs in cost-effectiveness analysis: numerator or denominator: a further discussion," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 511-514.
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Citations

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Cited by:
  1. Bonny Parkinson & Stephen Goodall & Richard Norman, 2013. "Measuring the Loss of Consumer Choice in Mandatory Health Programmes Using Discrete Choice Experiments," Applied Health Economics and Health Policy, Springer, vol. 11(2), pages 139-150, April.
  2. Mark Sculpher & Karl Claxton, 2010. "Sins of omission and obfuscation: IQWIG's guidelines on economic evaluation methods," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1132-1136.
  3. Karl Claxton & Mark Sculpher & Stuart Carroll, 2011. "Value-based pricing for pharmaceuticals: Its role, specification and prospects in a newly devolved NHS," Working Papers 060cherp, Centre for Health Economics, University of York.
  4. Hareth Al-Janabi & Nikki McCaffrey & Julie Ratcliffe, 2013. "Carer Preferences in Economic Evaluation and Healthcare Decision Making," The Patient: Patient-Centered Outcomes Research, Springer, vol. 6(4), pages 235-239, December.
  5. Ana Bobinac & Job Exel & Frans Rutten & Werner Brouwer, 2014. "The Value of a QALY: Individual Willingness to Pay for Health Gains Under Risk," PharmacoEconomics, Springer, vol. 32(1), pages 75-86, January.

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