• Understanding different economic approaches to health care evaluations, such as decision theoretical approaches, multiple criteria approaches, and modern benchmarking theories in order to understand the costs, benefits, success and failure of health care innovation
• Obtain knowledge about the most important approaches to health economic evaluation including health technology assessment, cost-benefit analysis, cost-effectiveness analysis and newer techniques like multi criteria decision analysis (MCDA)
• Ability to analyse health care innovations by applying the most recent health economic approaches
• Understand the structure of a full and rapid HTA report
• Understand how economic assessments can be used in decision making, its usefulness and its limitations
• Apply health economic assessment techniques to actual case examples regarding health care innovation

Health Technology Assessment and Advanced Cost Benefit:

There is an increasing pressure on health care budgets in most health systems. Increasing health care demands and limited budgets force health care decision makers to prioritise among the set of possible health interventions including new health care innovations and existing health services.

A range of assessment methodologies can be utilised to assemble and synthesize information on benefits and resources needed for different health interventions and may be used to inform the priority setting and decision making in the health care system. The results of these assessment techniques are relevant for decision makers both in public health care systems and insurance based systems.

The purpose of this course is to introduce the most important and recent assessment techniques used in the health care sector with a focus on economic evaluation methods. This course will enable course participants to analyse health care decision problems and apply assessment techniques to real decision problems as well as cases.

The first part of the course will present the theoretical background to economic evaluation and decision making in health care sector based mainly on economic theory. Decision making in both public health care and insurance based systems will be covered hereunder the role of modelling in health care decision making. Some of the complications of real evaluations will be introduced.

The second part will cover the common economic evaluation techniques including cost-benefit analysis (CBA), cost-effectiveness analysis (CEA) and cost-utility analysis (CUA). This section will examine a broad range of topics relevant for these techniques including identification of relevant costs, measurement of health gains, health state valuation, measure the level and characterise uncertainty, value of information analysis, decision models and Markov models.

Attention will also be given to health technology assessment (HTA). HTA builds on the above techniques but takes a broader perspective by synthesizing relevant evidence and knowledge on such additional aspects as the health technology itself, the patients and the organisation of health services. It contributes to priorities and decisions in relation to e.g. prevention, diagnosis, treatment and rehabilitation.

The course will continue with the introduction of newer techniques; many health care decisions – such as portfolio optimization, benefit-risk assessment and HTA – require a careful examination of the underlying options and the criteria used to evaluate these options, but the trade-offs between multiple value criteria can make this increasingly difficult. Multi criteria decision analysis (MCDA) enables a systematic ranking of health interventions in a situation where the decision maker has more criteria than just cost and benefits.  Value-based pricing will also be covered.

A series of application case studies will be covered.

The fundamentals of statistical methodology that underpin health technology assessment will be introduced. This will equip students with the necessary statistical skills to analyse and interpret data that commonly arise from HTAs. The course will conclude with a case analysis. A specific evaluation problem will be introduced by an industry or government representative. The students, working in groups of 3-4, will analyse the problem and develop an appropriate assessment of the presented case. Their suggestions are presented as short 15 minute summaries for the rest of the class and the industry/authority representative. Finally, each student will create a three pages executive summary of their suggestions and the next steps necessary to implement it. In addition, this case may form the basis of the written assignment that must be finalised before the oral exam.

Faculty:

Kristian Schultz Hansen, Associate Professor (external), ECON, and Institute of Public Health, University of Copenhagen   

Laila Kærgaard Starr, PhD Fellow, ECON