1. ECONOMIC EVALUATION WHY DO YOU NEED TO BOTHER? JUDITH BOSMANS

2. Faculteit der Aard- en Levenswetenschappen WHY BOTHER ABOUT ECONOMICS IN HEALTH CARE? 2Meet & Greet Triple-E, 8 May 2014 Limited budgets available for health care hard choices We want to maximize outcomes and minimize costs. Economic evaluations provide the information needed to make these decisions

3. Faculteit der Aard- en Levenswetenschappen WHAT IS AN ECONOMIC EVALUATION? 3Meet & Greet Triple-E, 8 May 2014 Economic evaluation: comparison of costs and effects of two or more medical interventions Comparison needed with usual care for the disorder under study TypeOutcome Cost-effectiveness analysis (CEA)Disease-specific measures Cost-utility analysis (CUA)Quality-Adjusted Life-Years (QALYs) Cost-benefit analysis (CBA)Outcomes expressed in monetary units

4. Faculteit der Aard- en Levenswetenschappen COST-BENEFIT ANALYSIS 4Meet & Greet Triple-E, 8 May 2014 Comparison possible between all kinds of spending opportunities Healthcare Education Safety Etcetera Difficulty: what are you willing to pay for one unit of effect?

5. Faculteit der Aard- en Levenswetenschappen CEA VERSUS CUA 5Meet & Greet Triple-E, 8 May 2014 CEA: disease-specific outcomes Useful for healthcare providers Only comparison possible between interventions for the same disorder But… healthcare decision makers need to choose between interventions for different conditions… CUA:QALYs = # of life-years adjusted for loss of quality of life

6. Faculteit der Aard- en Levenswetenschappen SUMMARY MEASURE IN ECONOMIC EVALUATIONS 6Meet & Greet Triple-E, 8 May 2014 Incremental Cost-Effectiveness Ratio (ICER) Costs INTERVENTION - Costs CONTROL Effects INTERVENTION - Effects CONTROL eHealth InterventionUsual care Healthcare utilization Lost productivity Implementation eHealth Coaching

7. Faculteit der Aard- en Levenswetenschappen COST-EFFECTIVENESS PLANE 7Meet & Greet Triple-E, 8 May 2014 NW more expensive less effective DOMINATED SW less expensive less effective TRADE-OFF SE less expensive more effective DOMINANT NE more expensive more effective TRADE-OFF Incremental costs Incremental effects Are the additional effects worth the extra costs? Are we willing to trade off some effect to save money?

8. Faculteit der Aard- en Levenswetenschappen SO WHY BOTHER ABOUT ECONOMIC EVALUATIONS? 8Meet & Greet Triple-E, 8 May 2014 It will provide important information for policy makers at different levels Governmental level Healthcare insurer level Healthcare provider level It can help to allocate scarce resources

9. Faculteit der Aard- en Levenswetenschappen 9Meet & Greet Triple-E, 8 May 2014 Efficient! Fair?