Cost-Effectiveness Analysis in
Health: A Practical Approach, 2nd Edition
Peter Muennig
Hardcover: 384 pages
ISBN 0787995568
978-0787995560
Jossey-Bass
November 2007
(Click button below for best currently available price for this
title)
This edition of Cost Effectiveness
Analysis in Health reviews issues and methods of assessing
health care technologies and related programs.
It emphasizes methods to perform
economic evaluations, such as cost-effectiveness and cost-benefit
analysis; methods to assess efficacy, effectiveness, and safety of
health care technologies; effectiveness research; and applications
to clinical and public policy.
The book provides in-depth discussion of
the uses and conducting of cost-effectiveness analyses (CEAs) as
decision-making aids in public health, health services, and
medicine. It explores cost-effectiveness in the context of societal
decision making for resource allocation purposes. Chapter topics
include:
defining and explaining
cost-effectiveness,
principles of cost-effectiveness
analysis,
how to develop a research project,
working with costs,
probabilities and models,
calculating life expectancy,
working with health-related quality
of life measures,
calculating quality-adjusted life
years,
conducting a sensitivity analysis,
preparing your study for
publication,
working with data,
finding the data you need,
and more.
Peter Muennig is an assistant professor
at Columbia University. Previously, he directed the Program in
Cost-Effectiveness and Outcomes at New School University, consulted
for Health Canada and the Centers for Disease Control and Prevention
(CDC), and was an assistant professor at the Sophie Davis School of
Biomedical Education.
Table of Contents: List of Tables, Figures, and Exhibits ix
Preface xiii
The Author xvi
Introduction to Cost-Effectiveness 1
Overview 1
Why Cost-Effectiveness Is Useful 3
Elements of Cost-Effectiveness Analysis 4
The Cost-Effectiveness Ratio 8
Why Conduct Cost-Effectiveness Analysis? 9
The Reference Case Analysis 12
Cost-Effectiveness Analysis and Policy 14
Principles of Cost-Effectiveness Analysis 19
Overview 19
The Perspective of a Cost-Effectiveness Analysis 19
Capturing Costs 22
Capturing Quality 23
Interpreting the Cost-Effectiveness Ratio 27
Types of Economic Analysis 30
Developing a Research Project 36
Overview 36
Eight Steps to a Perfect Research Project 36
Developing a Research Question 38
Designing Your Analysis 43
Working with Costs 50
Overview 50
Opportunity Costs 51
Identifying Costs 52
Micro-Costing and Gross Costing 55
Getting Cost Data 57
Using Diagnosis Codes 59
Adjusting Costs 60
Costs Associated with Pain and Suffering 69
Assessing the "Relevancy" of Cost Data 70
Other Cost Considerations 71
Probabilities and Models 75
Overview 75
Probabilities 75
Decision Analysis Models 79
Calculating Life Expectancy 87
Overview 87
Hand-Calculating Years Gained 88
Calculating Life Years Lost Using Markov Models 92
Working with Health-Related Quality-of-Life Measures 104
Overview 104
Framework 105
Deriving HRQL Scores 108
Other Considerations and Reminders 115
Using Disability-Adjusted Life Years 116
Calculating QALYs 117
Overview 117
Using the Summation Method 118
Using the Life Table Method 119
Calculating Incremental Cost-Effectiveness 132
Disability-Adjusted Life Year (DALY) 136
Conducting a Sensitivity Analysis 137
Overview 137
One-Way Sensitivity Analysis 139
Two-Way Sensitivity Analysis 142
Analysis of Influence 143
Monte Carlo Simulation 143
Determining the Plausible Range of Each Variable 147
Preparing Your Study for Publication 149
Overview 149
Content and Structure of Cost-Effectiveness Articles 149
Introduction 151
Methods 151
Results 153
Technical Appendix 154
Working with Data 155
Overview 155
Review of Rates 156
Understanding Error 160
Managing Error in Cost-Effectiveness Analysis 162
Calculating Weighted Means 168
Evaluating Study Limitations 170
Finding the Data You Need 179
Overview 179
Finding Data in the Medical Literature 180
Grading Published Data 180
Using Electronic Datasets 180
Using Unpublished Data 188
Using Data from Piggybacked Studies 188
Using Expert Opinion 189
Organizing Your Data 189
Answer Key to Exercises 191
Life Expectancy and Quality-Adjusted Life Expectancy Tables 197
EuroQol Instrument and Weighting Scheme 201
Diagnosis, Charges, Medicare Reimbursement, Average Length of Stay,
and Cost-to-Charge Ratio by Diagnosis-Related Groups, 2004 203
Glossary 249
References 255
Index 259
