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Abstract/Syllabus:
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Understanding Cost-Effectiveness Analysis in Health Care
Spring 2005

Cost analysis can help determine appropriate resources for
preventing premature births.
Instructor
Kevin Frick
Offered By
Health Policy and Management
Description
The primary objective of this content is to prepare students to read and interpret cost-effectiveness studies. The students will first be introduced to basic economic concepts that are needed in order to understand the recommendations from the United States Panel on Cost Effectiveness in Health and Medicine. One example is the distinction between opportunity costs and budgetary costs. The recommendations will then be reviewed, particularly as they apply to what students should expect to read in cost-effectiveness research reports. Next, the relationship between cost-effectiveness results and other elements of the health care policy decision-making process will be discussed. More information will be provided on several aspects of how to conduct cost-effectiveness analyses. A critical discussion of several current articles demonstrating cost-effectiveness analyses will be an integral part of this course. When a student has completed this course, he or she will be able to read, comprehend, and perform a basic critique of cost-effectiveness papers and take part in discussions of planned cost-effectiveness research.
Syllabus
Course Description
The primary objective of this course is to prepare students to read and interpret cost-effectiveness studies. The students will first be introduced to basic economic concepts that are needed in order to understand the recommendations from the United States Panel on Cost Effectiveness in Health and Medicine. One example is the distinction between opportunity costs and budgetary costs. The recommendations will then be reviewed, particularly as they apply to what students should expect to read in cost-effectiveness research reports. Next, the relationship between cost-effectiveness results and other elements of the health care policy decision-making process will be discussed. More information will be provided on several aspects of how to conduct cost-effectiveness analyses. A critical discussion of several current articles demonstrating cost-effectiveness analyses will be an integral part of this course. When a student has completed this course, he or she will be able to read, comprehend, and perform a basic critique of cost-effectiveness papers and take part in discussions of planned cost-effectiveness research.
Course Objectives
By the end of the course, students should be able to do the following:
- Read and interpret cost-effectiveness studies.
Prerequisites
You must successfully complete Introduction to Online Learning (550.002.81), offered by the Distance Education Division. For more information and to register, visit the Introduction to Online Learning course Web site.
There are no economic, budgeting, or accounting prerequisites.
Readings
Required Materials
- Readings: Article readings are available via the Welch Medical Library E-Reserves System. Instructions on how to access course readings are provided on individual lecture pages.
- Textbook: Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation: Second Edition, by A.C. Haddix, S.M. Teutsch, P.S. Corso (editors).
You can buy the textbook from any online bookstore or through the Matthews Johns Hopkins Medical Book Center.
Matthews Johns Hopkins Medical Book Center
1830 East Monument Street
Baltimore, MD 21205 USA
410.955.3931
800.266.5725
410.955.0576 Fax
http://www.jhumedbooks.com/
Time Commitment
On average, students should expect to spend six hours per week on a two-unit course at the School of Public Health.
Course Topics
This course covers the following topics:
- Economic concept overview
- Recommendations of the Panel on Cost-Effectiveness in Health and Medicine
- Decision rules
- Quality adjusted life years
- One year cost calculations
- Multiple year cost calculations
- Examples from readings
Course Format
Lectures: There will be eight lectures. Each lecture is approximately one hour long and is divided into three sections of approximately twenty minutes. Students will be expected to read materials relevant to each lecture before they view the online presentation.
Practical Exercises: There will be three exercises that will help students understand the basics of how costs and quality adjusted life years are calculated.
LiveTalk Sessions: The instructor will lead six online LiveTalk sessions for the purpose of answering questions, reviewing exercises, discussing articles, and moderating the exchanges between students. There also will be an electronic bulletin board in which students may post any course-related messages.
Final Paper: At the end of the course, students will submit an essay (no longer than ten pages double-spaced) in which they demonstrate their mastery of the course material. Details are provided in the syllabus. There will be no examinations.
Grading Policy
Students will be expected to submit exercises and the final paper on time and to participate actively in the LiveTalk sessions and BBS discussions. Students taking this course for graduate academic credit will be evaluated based on three exercises and a final paper. Grades will be computed as follows:
- Participation: 10%
- Final paper: 60%
- Practical exercises: 30%
The final letter grade will be based on the following point system:
- A = 90-100
- B = 80-89
- C = 70-79
- P = 70 + (For those taking the course pass/fail)
- D = 60-69
- F = < 59
Schedule
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Economics Concepts Overview |
Lecture 1 |
Solidifying Underlyinc Concepts |
LiveTalk 1 |
Recommendations of the Panel on Cost-Effectiveness in Health and Medicine |
Lecture 2 |
Solidifying Concepts from Recommendations |
LiveTalk 2 |
Decision Rules |
Lecture 3 |
Discussion of decision rules and how the rules apply to cancer treatment. |
LiveTalk 3 |
Decision rules |
Exercise 1 |
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Quality Adjusted Life Years |
Lecture 4 |
Discussion of the concepts behind QALYs, implications of using QALYs, and how QALYs were calculated in the Discussion III piece. |
LiveTalk 4 |
QALYs |
Exercise 2 |
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Measuring Cost Over Time |
Lecture 5 |
Multiple Year Cost Calculations |
Lecture 6 |
Solidifying Cost Concepts |
LiveTalk 5 |
Costs |
Exercise 3 |
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Putting It All Together (with examples from the readings). |
Lecture 7 |
Any outstanding issues. |
LiveTalk 6 |
Final Assignment |
Final assignment |
Course Evaluation |
Course Evaluation. Student input is a highly-valued source of information when doing course revisions. As such, please take a minute to fill out the end of course evaluation. |
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Further Reading:
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Readings
Reading List (21KB) This document contains a comprehensive list of all readings, including those for the live chat sessions.
Textbooks
Haddix AC, Teutsch SM, Corso PS (eds). Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation: Second Edition. 2002. Oxford University Press.
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1 |
Economics Concepts Overview |
Phillips KA, Chen JL. Impact of the U.S. panel on cost-effectiveness in health and medicine. Am J Prev Med. 2002; 22(2): 98-105.
Saha S, Hoerger TJ, Pignone MP, Teutsch SM, Helfand M, Mandelblatt JS; Cost Work Group, Third US Preventive Services Task Force. The art and science of incorporating
cost effectiveness into evidence-based recommendations for clinical preventive services. Am J Prev Med. 2001; 20(3 Suppl): 36-43.
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2 |
Recommendations of the Panel on Cost-Effectiveness in Health and Medicine |
Ramsey SD, Moinpour CM, Lovato LC, Crowley JJ, Grevstad P, Presant CA, Rivkin SE, Kelly K, Gandara DR. Economic analysis of vinorelbine plus cisplatin versus paclitaxel plus carboplatin for advanced non-small-cell lung cancer. J Natl Cancer Inst. 2002; 94(4): 291-7.
Ramsey SD, Kessler LG. Does economics matter when treating advanced non-small cell lung cancer? Oncologist. 2002; 7(3): 179-80.
Roberts TG Jr, Lynch TJ Jr, Chabner BA. Choosing chemotherapy for lung cancer based on cost: not yet. Oncologist. 2002; 7(3): 177-8. |
3 |
Decision Rules |
Schackman BR, Freedberg KA, Weinstein MC, Sax PE, Losina E, Zhang H, Goldie SJ. Costeffectiveness implications of the timing of antiretroviral therapy in HIV-infected adults. Arch Intern Med. 2002; 162(21): 2478-86. |
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4 |
Quality Adjusted Life Years |
Mahadevia PJ, Fleisher LA, Frick KD, Eng J, Goodman SN, Powe NR. Lung cancer screening with helical computed tomography in older adult smokers: a decision and cost-effectiveness analysis. JAMA. 2003; 289(3): 313-22. |
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5 |
Measuring Cost Over Time |
Samsa GP, Reutter RA, Parmigiani G, Ancukiewicz M, Abrahamse P, Lipscomb J, Matchar DB. Performing cost-effectiveness analysis by integrating randomized trial data with a comprehensive decision model: application to treatment of acute ischemic stroke. J Clin Epidemiol. 1999; 52(3): 259-71. |
6 |
Multiple Year Cost Calculations |
Lieu TA, Ray GT, Black SB, Butler JC, Klein JO, Breiman RF, Miller MA, Shinefield HR. Projected cost-effectiveness of pneumococcal conjugate vaccination of healthy infants and young children. JAMA. 2000; 283(11): 1460-8. |
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Content 1 |
Putting It All Together (with examples from the readings) |
Lee PY, Matchar DB, Clements DA, Huber J, Hamilton JD, Peterson ED. Economic analysis of influenza vaccination and antiviral treatment for healthy working adults. Ann Intern Med. 2002; 137(4): 225-31. |
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