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Comparing the Analysis and Results of a Modified Social Accounting Matrix Framework with Conventional Methods of Reporting Indirect Non-Medical Costs


  • Baudouin Standaert

    (HEBO bv)

  • Christophe Sauboin

    (The University Medical Center Groningen
    Boehringer Ingelheim, Global Market Access Excellence)

  • Quentin J. Leclerc

    (London School of Hygiene and Tropical Medicine)

  • Mark P. Connolly

    (University of Groningen)


Background Assessing the societal perspective in economic evaluations of new interventions requires estimates of indirect non-medical costs caused by the disease. Different methods exist for measuring the labor input function as a surrogate for these costs. They rarely specify the effect of health on labor and who gains and who loses money. Social accounting matrix (SAM) is an established framework that evaluates public policies with multiple perspectives that could help. Objectives We evaluated the use of a modified SAM to assess money flows between different economic agents resulting in economic transactions following policy changes of medical interventions. Methods We compared conventional methods of measuring indirect non-medical costs related to rotavirus vaccination in the Netherlands with a modified SAM framework. To compare the outcome of each method, we calculated returns on investment (ROI) as the net amount of money per euro invested in the vaccine. One-way and probabilistic sensitivity analyses were carried out for each method, focusing on critical variables with the largest impact on indirect cost estimates. Results The ROI was higher for the modified SAM (1.33) than for the conventional methods assessing income calculations (range − 0.178 to 1.22). Probabilistic sensitivity analyses showed wide distributions in the ROI estimates, with variation in the variable impact on the indirect cost results per method selected. Conclusions In contrast to conventional methods, the SAM approach provides detailed and comprehensive assessments of the impact of new interventions on the indirect non-medical costs and the financial interactions between agents, disclosing useful information for different stakeholders.

Suggested Citation

  • Baudouin Standaert & Christophe Sauboin & Quentin J. Leclerc & Mark P. Connolly, 2021. "Comparing the Analysis and Results of a Modified Social Accounting Matrix Framework with Conventional Methods of Reporting Indirect Non-Medical Costs," PharmacoEconomics, Springer, vol. 39(2), pages 257-269, February.
  • Handle: RePEc:spr:pharme:v:39:y:2021:i:2:d:10.1007_s40273-020-00978-4
    DOI: 10.1007/s40273-020-00978-4

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    References listed on IDEAS

    1. Alfredo J. Mainar Causape & Emanuele Ferrari & Scott McDonald, 2018. "Social accounting matrices: basic aspects and main steps for estimation," JRC Research Reports JRC112075, Joint Research Centre (Seville site).
    2. Jamison Pike & Scott D. Grosse, 2018. "Friction Cost Estimates of Productivity Costs in Cost-of-Illness Studies in Comparison with Human Capital Estimates: A Review," Applied Health Economics and Health Policy, Springer, vol. 16(6), pages 765-778, December.
    3. Simon Walker & Susan Griffin & Miqdad Asaria & Aki Tsuchiya & Mark Sculpher, 2019. "Striving for a Societal Perspective: A Framework for Economic Evaluations When Costs and Effects Fall on Multiple Sectors and Decision Makers," Applied Health Economics and Health Policy, Springer, vol. 17(5), pages 577-590, October.
    4. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    5. Barr, Nicholas, 2012. "Economics of the Welfare State," OUP Catalogue, Oxford University Press, edition 5, number 9780199297818.
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    Blog mentions

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    1. Chris Sampson’s journal round-up for 15th March 2021
      by Chris Sampson in The Academic Health Economists' Blog on 2021-03-15 12:00:14

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