Methods for the Economic Evaluation of Health Care Programmes

Article excerpt

Methods for the economic evaluation of health care programmes Drummond M, Schulper M, Torrance G, O'Brien B and Stoddart G 3rd edition, Oxford University Press, 2005 ISBN: 019-852945-7. RRP $99.95. 350 pages

AS THE NAME SUGGESTS, Methods for the economic evaluation of health care programmes, third edition, is a recently updated and revised textbook that explores the various forms of economic evaluation - applied to the health care setting. However, at first glance, the title of this book could be slightly misleading. One might even mistake it for being yet another introductory text in health economics! Indeed, it is quite the contrary, as the authors have gone beyond merely describing methods of economic evaluation, to critically evaluating the methods per se.

The authors have managed to deliver a comprehensive text which enables its readers to reach beyond the basics of economic evaluation and ultimately prepare themselves for some "handson" experience when dealing with contentious or "thorny" issues in the real world.

There are currently a number of good introductory texts in health economics and this book is clearly intended as a supplement (and not a substitute) for these.

The text comprises 11 chapters in which the following key points are covered:

* A quick introduction to the basic forms of evaluation;

* A guide to critically appraising economic evaluations;

* Four chapters discussing the methodological issues in the main forms of evaluation;

* Two chapters exploring the use of the main approaches for data collection in economic evaluation; and

* Two final chapters dealing with the presentation and use of economic evaluation results, followed by the author's own "survival guide" for evaluators.

The first two chapters provide a brief overview of the book, followed by a short introduction to the basic methods of economic evaluation. The authors also touch on some of the issues to be discussed in later chapters. Chapter 3 provides a comprehensive checklist for assessing economic evaluations, followed by supportive notes to each question, and critical appraisal exercises at the end of other chapters (3, 5 and 6). Chapters 4, 5, 6 and 7 are spent discussing the four main forms of economic evaluation - cost analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis - and form the main part of the book. The allocation of overhead costs and discussion on estimating productivity changes are dealt with well in Chapter 4. Chapter 5 introduces the notion of "net benefits" as a proxy for measuring the "value for money" of health care programmes. A very strong theoretical grounding for cost-utility analysis has been incorporated into Chapter 6, and this is followed by some useful exercises on calculating quality-adjusted life-years and healthy-year equivalents. Chapter 7 introduces and explores the measurement technique of "willingness-to-pay", and Chapters 8 and 9 effectively deal with analysing patient-level data and decision-analytic modelling. The remaining two chapters discuss the problems, potential and transferability of economic evaluation results to other settings (Chapter 10) and, finally, the economic evaluators "survival guide" in Chapter 11.

The text has been written by internationally recognised health economics "gurus" in a clear and concise manner and, at times, the authors have even added their own cheeky touch of humor. …