Health Economic Evaluation

  • European Master in Health Economics and Management
Course unit code
  • IHCM2ECO2201
Level of course unit
  • Master
Semester when the course unit is delivered
  • 2
Number of ECTS credits allocated
  • 5.0
Name of lecturer(s)
  • Prof. Durand-Zaleski Isabelle, MD, PhD
  • Dr. Fidler Armin, MD, MPH, MSc
Learning outcomes of the course unit
  • This course is about being able to make your own opinion about new health technologies in the context of your health care system. You should be able to understand the medical and economic information that is presented to you (eg by healthcare professionals, manufacturers, patients’ advocates) and to analyze it.
    You know that health care expenditures and entitlement to health care are highly debated topics at the moment, and this course will give you some methods to sort out the issues and find your own answers.
    The main topics covered in this course are:
    - What is evidence in healthcare (both medical and economic)
    - Who are the stakeholders
    - How do healthcare systems operate
    Students should get a deep knowledge of the methods at hand for evaluation of diagnostic and therapeutic technologies within health care. The course should provide the necessary tools for understanding the literature in the field, and to carry out a simple economic evaluation. Students should understand the relevance of these methodologies for health policy and planning.
Mode of delivery
  • blended learning
Prerequisites and co-requisites
  • none
Course contents
  • Welfare foundations of cost-benefit analysis
    The Pareto criterion and other welfare criteria; market failure and non-market decision-making; social welfare functions
    The monetary value of health changes
    Private willingness-to-pay under certainty; health risks and the valuation of health under uncertainty; altruistic willingness-to-pay.
    The resource consequences of health changes
    Valuing resource consequences due to changes in morbidity and mortality in a private system under conditions of certainty and uncertainty; valuing resource consequences in a public system under certainty and uncertainty.
    Valuing health: the revealed preference approach
    Wage-risk studies; the insurance approach; hedonic property value studies; implied values from observed trade-offs between time and safety.
    Valuing health: the expressed preference approach
    Contingent valuation studies; open-ended vs binary questions; potential biases; empirical applications to health.
    The estimation of costs
    Programme costs - the costs of the intervention; market failures and the use of market prices; morbidity and mortality costs.
    Economic rationale of discounting; opportunity cost of capital vs time preference; criticisms of discounting.
    Cost-effectiveness analysis
    Measuring health outputs in non-monetary terms; intermediate vs final health outputs; decision rules with independent and mutually exclusive programmes; incremental analysis - defining the comparator; applied studies in the health sector.
    Cost-utility analysis
    Cost-effectiveness vs cost-utility analysis; quality-adjusted life-years (QALYs); eliciting utility weights for health states; QALYs, individual preferences and attitudes to risk; QALYs, health-year equivalents (HYEs) and disability-adjusted life-years (DALYs); applied studies in the health sector.
    Equity issues
    Efficiency and equity; welfare criteria and equity; the role of equity in economic evaluation.
    Economic evaluation and policy-m

    Please be aware that this course requires high level of proficiency in English language. All local students have passed an English language test with at least 90 TOEFL points (internet based) or comparable tests.
Recommended or required reading
  • Books
    Required Readings:
    Folland S, Goodman AC and Stano M. 2007. "The Economics and Health and Health Care, Fifth Edition." Upper Saddle River, NJ: Pearson Prentice Hall
    Gold MR, Siegel JE, Russell LB, Weinstein MC (Eds.). 1996. Cost-Effectiveness in Health and Medicine. New York, NY: Oxford University Press.
    Mossialos E, A Dixon, J Figueras, J Kutzin, Funding health care: options for Europe, Open University Press, Buckingham, Philadelphia, 2002. Paolucci, F.: The design of basic and supplementary health care financing
    schemes: implications for efficiency and affordability, December 2007,
    Erasmus University Repository, Rotterdam, The Netherlands
    Thomson S, T Foubister and E Mossialos. (2009). Chapter 2: Health Care Financing in the European Union. In Financing Health Care in the European Union: Challenges and Policy Responses. European Observatory on Health Systems and Policies, Observatory Study Series No. 17. Pages 24-47.
    In addition to this hints for further reading will be given in the handouts of the course. Please check Sakai

    Isabelle Durand:
    Drummond MF. 2006. Methods for the Economic Evaluation of Health Care Programmes, 3rd edition. Oxford Medical Publications.
    Gold MR, Siegel JE, Russell LB, Weinstein MC (Eds.). 1996. Cost-Effectiveness in Health and Medicine. New York, NY: Oxford University Press.
    Nutley SM, Davies HTO, and Smith PC (Eds.). 2000. What works? Evidence based policy and practice in public services. Bristol, UK: Policy Press.
    Rossi PH, Lipsey MW, and Freeman HE. 2003. Evaluation: A Systematic Approach, 7th edition. Thousand Oaks, CA: Sage Publications.
    Rogers EM. 2003. Diffusion of Innovations, 5th Edition. New York, NY: Free Press.
Planned learning activities and teaching methods
  • In order to acquire the skills of HTA, students will perform exercises on published articles. Off line activities also include a discussion forum.
    Students form groups of 5-6 persons, making sure that at least one person has a background in medicine, nursing, pharmacy or physical therapy. In the past, students have also formed groups by nationality, which facilitates discussions but somewhat limits the understanding of cultural aspects of HTA.
Assessment methods and criteria
  • To monitor the students’ learning this course will provide ongoing assignments as a basis for feedback and grading (formative assessment) and/or will evaluate the students learning at the end of the course or an instructional unit via exams, final project reports, essays or seminar papers (summative assessment).
Language of instruction
  • English