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Distributional Cost-Effectiveness Analysis of Health Care Programmes

Author

Listed:
  • Miqdad Asaria

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

  • Susan Griffin

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

  • Richard Cookson

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

  • Sophie Whyte

    (School of Health and Related Research, University of Sheffield, UK)

  • Paul Tappenden

    (School of Health and Related Research, University of Sheffield, UK)

Abstract

This paper presents a case study application of a new methodological framework for undertaking distributional cost-effectiveness analysis (DCEA) to combine the objectives of maximising health and minimising unfair variation in health when evaluating population health interventions. The NHS Bowel Cancer Screening Programme (BCSP) introduced in 2006 is expected to improve population health on average but also to worsen population health inequalities associated with deprivation and ethnicity – a classic case of intervention generated inequality. We demonstrate the DCEA framework by examining two redesign options for the BCSP: (1) the introduction of an enhanced targeted reminder aimed at increasing screening uptake in deprived and ethnically diverse neighbourhoods and (2) the introduction of a basic universal reminder aimed at increasing screening uptake across the whole population. Our analysis indicates that the universal reminder is the strategy that maximises population health while the targeted reminder is the screening strategy that minimises unfair variation in health. The framework is used to demonstrate how these two objectives can be traded off against each other, and how alternative social value judgements influence the assessment of which strategy is best, including judgements about which dimensions of health variation are considered unfair and judgements about societal levels of inequality aversion.

Suggested Citation

  • Miqdad Asaria & Susan Griffin & Richard Cookson & Sophie Whyte & Paul Tappenden, 2013. "Distributional Cost-Effectiveness Analysis of Health Care Programmes," Working Papers 091cherp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:91cherp
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    References listed on IDEAS

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    Cited by:

    1. 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.
    2. Olanrewaju Medu & Adegboyega Lawal & Doug Coyle & Kevin Pottie, 2021. "Economic evaluation of HIV testing options for low-prevalence high-income countries: a systematic review," Health Economics Review, Springer, vol. 11(1), pages 1-11, December.
    3. Miqdad Asaria, 2017. "Health care costs in the English NHS: reference tables for average annual NHS spend by age, sex and deprivation group," Working Papers 147cherp, Centre for Health Economics, University of York.
    4. Miqdad Asaria & Susan Griffin & Richard Cookson, 2013. "Distributional cost-effectiveness analysis: a tutorial," Working Papers 092cherp, Centre for Health Economics, University of York.
    5. Micaela Pinho & Anabela Botelho, 2018. "Inference Procedures to Quantify the Efficiency–Equality Trade-Off in Health from Stated Preferences: A Case Study in Portugal," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 503-513, August.
    6. Emma Frew, 2017. "Aligning Health Economics Methods to Fit with the Changing World of Public Health," Applied Health Economics and Health Policy, Springer, vol. 15(3), pages 287-289, June.
    7. Richard Cookson & Shehzad Ali & Aki Tsuchiya & Miqdad Asaria, 2018. "E‐learning and health inequality aversion: A questionnaire experiment," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1754-1771, November.
    8. Lakdawalla, Darius N. & Phelps, Charles E., 2020. "Health technology assessment with risk aversion in health," Journal of Health Economics, Elsevier, vol. 72(C).
    9. Stéphane Verguet & Jane J. Kim & Dean T. Jamison, 2016. "Extended Cost-Effectiveness Analysis for Health Policy Assessment: A Tutorial," PharmacoEconomics, Springer, vol. 34(9), pages 913-923, September.
    10. Ngalesoni, Frida N. & Ruhago, George M. & Mori, Amani T. & Robberstad, Bjarne & Norheim, Ole F., 2016. "Equity impact analysis of medical approaches to cardiovascular diseases prevention in Tanzania," Social Science & Medicine, Elsevier, vol. 170(C), pages 208-217.
    11. Mark Sculpher & Stephen Palmer, 2020. "After 20 Years of Using Economic Evaluation, Should NICE be Considered a Methods Innovator?," PharmacoEconomics, Springer, vol. 38(3), pages 247-257, March.
    12. Carlos Campillo-Artero & Jaume Puig-Junoy & Anthony J. Culyer, 2018. "Does MCDA Trump CEA?," Applied Health Economics and Health Policy, Springer, vol. 16(2), pages 147-151, April.

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