1 by Donald S. Shepard, Ph.D. Schneider Institute for Health Policy Heller School, MS 035 Brandeis University Waltham, MA USA Tel: Fax: Web: Monday, Oct. 15: Applications of CE analysis To Other Sectors

2 Practical information Teaching assistant: Administrative assistant: Linda Purrini, Next to library in Heller Cost of packet: $6.00

3 Objective for class Help us identify illustrative, empirical, preferably intervention studies outside of the health sector Collect and read the selected studies (distributed later this week) Be prepared to discuss the cost-effectiveness framework: What are the alternative(s)? What are the costs? What are the outcomes (effectiveness)? How do we interpret cost-effectiveness results?

4 Cost effectiveness of three types of schools (A Pakistan case study) by Fazal ur Rehman Faisal Islam SID Program December 15, 2000

5 Source of effectiveness data Study conducted by ActionAid Pakistan[1] in late 1998 to assess the learning achievements of grade IV students[1] [1] ActionAid is an international U.K based non-governmental organsation working in more than 30 countries around the globe to bring lasting changes in the life of poor people.

6 Initial cost data

7 Where’s the glitch?

8 Capital cost data

9 Key findings

10 Cost-effectiveness of schools in Pakistan (raw data)

11 Adjustment of effectiveness data

12 Cost-effectiveness of schools in Pakistan (adjusted data)

13 Final Assignment of CE module, 1 Purpose: See how cost-effectiveness analysis can be applied to a subject of interest to you. Background: Select and cite an article or report of interest to you that describes the effectiveness or cost-effectiveness of a clinical intervention or program in a human services sector. For suggestions or help in identifying articles, see the instructor or teaching assistant. For example, the instructor’s report, “Economic analysis of anti-viral therapy in Botswana” provides data on the cost-effectiveness of AZT for pregnant women. A copy is available on the web site under “downloads.” Two types of papers are possible. Alternative A: Perform a preliminary cost-effectiveness analysis. If the study is an effectiveness study only, perform a preliminary cost-effectiveness analysis. Clearly indicate the alternatives you wish to compare and the effectiveness measure, and provide illustrative results. Use existing data where readily available, and explicitly assume values for other the unknown data. Interpret the findings. Discuss what kinds of data would be needed to convert the preliminary study into a more valid cost-effectiveness study, and where would they be obtained? Which items do you think are most critical?

14 Final Assignment of CE module, 2 Alternative B: Discuss a cost-effectiveness analysis. If the study is a cost- effectivenessstudy, discuss the appropriateness of the data, analysis, and interpretation, and put the results in a larger context. For example, compare the intervention under study with other interventions for the same disease or the same population. Submission: The length of the paper should be about 6 double spaced pages, including any tables or figures per student. Two or more students may work together and submit a joint paper that is proportionally more extensive, and longer if desired (6 pages per student). Please submit to Linda Purrini, administrative assistant, Heller G6, tel: , Also, please include a copy a summary, abstract, or full copy of the article with your submission. The paper may also be submitted electronically to Ms. Purrini. Schedule: Due Thursday, Oct. 25, 2001 (10 days after the last class). Evaluation: The module will be graded according to each student’s registration (audit, pass-fail, or letter grade) based on this final exercise, other exercises, and class participation. In addition, the instructors plan to give written comments on this exercise. The instructors look forward to your papers.