HERC: Cost-Effectiveness Analysis Course
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Cost-Effectiveness Analysis Course

Winter/Spring 2018 schedule to be announced. Archived 2016 course materials listed below.

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2016 Cost-Effectiveness Analysis Course
January 6, 2016
An Overview of Decision Analysis
Risha Gidwani, Dr.P.H. | Slides| Video

This lecture kicks off the HERC Cost-Effectiveness Analysis cyber course by providing an introduction to the field of decision analysis. Topics include: why to engage in decision analysis; the difference between cost-effectiveness analysis, cost utility analysis, cost-benefit analysis and budget impact analysis; and the different ways to operationalize a decision analysis (modeling versus measurement alongside a clinical trial). This lecture is aimed at providing a general high-level overview of the field.

January 13, 2016
Recommendations for Conducting Cost-Effectiveness Analysis: Elements of the Reference Case
Ciaran Phibbs, Ph.D. | Slides| Video

This lecture will present what the Public Health Service's cost-effectiveness guidelines refer to as the reference case. These are a standard set of methods and assumptions that should be used in the base or reference case of any cost-effectiveness analysis. Using a standard set of methods and assumptions greatly facilitates the comparison across cost-effectiveness studies; the ability to make comparisons across studies greatly increases the utility of all studies that meet these standards.

January 27, 2016
Estimating the Cost of an Intervention
Todd Wagner, Ph.D. | Slides| Video

Researchers are frequently engaged in developing and testing new behavioral interventions. In this lecture, we will discuss different methods for estimating the cost of new interventions.

February 3, 2016
VA Costs: HERC versus MCA
Jean Yoon, Ph.D. | Slides| Video

Researchers conducting cost-effectiveness analyses often need cost and utilization data. In this lecture, we will review the HERC Average Cost and the Managerial Cost Accounting (MCA; formerly Decision Support System (DSS)) data. We will briefly review the different datasets commonly used in research studies. We will also discuss how these data can be merged to VA utilization data.

February 10, 2016
Introduction to Effectiveness, Patient Preferences and Utilities
Josephine Jacobs, Ph.D. | Slides| Video

Cost-effectiveness analysis measures the benefit or health outcome of an intervention in natural units (like a flu episode avoided) or in quality-of-life improvement, defined by the quality-adjusted life years or QALY. This class will provide an introduction to the contents of QALYs and preference measurement and a description of the most common techniques used for measuring QALYs in economic evaluation.

February 24, 2016
Modeling in Medical Decision Analysis
Jeremy Goldhaber-Fiebert, Ph.D. | Slides| Video

This lecture will provide an introduction to decision analysis as applied to the context of medical and public health decision making. The lecture will cover the goals and necessary elements of a decision analysis, the construction and evaluation of decision trees and provide an introduction to how Markov models are embedded in decision analyses to consider more complex diseases. It will also discuss the important link between such analyses and cost-effectiveness analyses.

March 2, 2016
Estimating Transition Probabilities for a Model
Risha Gidwani, Dr.P.H. | Slides| Video

Inputs for a decision model often come from the published literature, but may not be in a form suitable for your decision model. For example, much of the literature contains Odds Ratios and Relative Risks, which need to be transformed into probabilities in order to be used in a model. Conversely, the literature may contain probabilities estimates, but they may not be relevant for the time frame of your model. This lecture will discuss ways of deriving probabilities that are specific to your model's contraints as well as deriving probabilities from published summary statistics. This lecture is aimed at the researcher who is interested in operationalizing his or her own decision model.

March 9, 2016
Evidence Synthesis to Derive Model Transition Probabilities (Part I - Systematic Literature Review)
Risha Gidwani, Dr.P.H. | Slides| Video

When there are multiple publications that have evaluated a parameter of interest (such as disease-related mortality or the efficacy of a treatment), one may be able to quantitatively synthesize these estimates into a single input for use in a decision model. This approach to evidence synthesis is called meta-analysis. This lecture will walk researchers through the process of conducting a meta-analysis from start to finish.

March 23, 2016
Evidence Synthesis to Derive Model Transition Probabilities (Part II - Quantitative Pooling)
Risha Gidwani, Dr.P.H. | Slides| Video

When there are multiple publications that have evaluated a parameter of interest (such as disease-related mortality or the efficacy of a treatment), one may be able to quantitatively synthesize these estimates into a single input for use in a decision model. This approach to evidence synthesis is called meta-analysis. This lecture will walk researchers through the process of conducting a meta-analysis from start to finish.

March 30, 2016
Sensitivity Analyses
Risha Gidwani, Dr.P.H. | Slides| Video

Inputs for a decision model come in the form of point estimates, and these point estimates inevitably have some degree of uncertainty. Sensitivity analyses test how robust the model is to this uncertainty by varying model inputs and evaluating the effect of these variations on model results. This lecture will cover deterministic and probabalistic sensitivity analyses, the latter of which is increasingly necessary in order to publish one's model in a peer-reviewed journal.

April 6, 2016
Budget Impact Analysis
Jim Burgess, Ph.D. | Slides| Video

A budget impact analysis (BIA) estimates the cost to a health care system, or other payer, of adopting a new or proposed intervention over 1-3 years. A BIA includes costs of the intervention and the implementation of the new intervention, as well as the downstream costs of healthcare utilization. It is often done alongside a clinical trial to estimate the costs of adoption, should the new intervention be found both clinically effective and cost-effective. This class will provide a framework for the BIA and tools to determine if a BIA is an appropriate economic study to undertake.

April 13, 2016
How can Cost-Effectiveness Analysis be Made More Relevant to U.S. Healthcare?
Paul Barnett, Ph.D. | Slides| Video

After providing a brief reminder of the elements of cost-effectiveness analysis, this lecture will describe how health policy decisions in other countries use it to set practice guidelines, determine pharmacy formularies, and make coverage decisisons. Attempts to formally incorporate cost-effectiveness into U.S. policy have failed, but there are many examples of informal use of cost-effectiveness findings. Surveys of decision makers have identified barriers to using cost-effectiveness findings to make health care decisions. Published recommendations provide economics researchers with tips on how to increase the chances that their findings will be implemented.


Cost-effectiveness courses taught outside VA

Other organizations teach cost-effectiveness workshops that are not specific to VA. Tuition is charged for all of these courses.

The Society for Medical Decision Making provides short courses in association with its annual meeting, held each October. In previous years, these have included half-day sessions on economic evaluation. For more information, see:
http://www.smdm.org/.

The Program for Assessment of Technology in Health (PATH), http://www.path-hta.ca/ affiliated with McMaster University in Ontario, Canada, has offered a workshop on Advanced Methods for the Economic Evaluation of Medicines. It currently offers a workshop on economic modeling. For more information, see: http://www.path-hta.ca/Workshops.aspx

Courses on economic evaluation have been offered by the Centre for Health Economics, The University of York, UK.
http://www.york.ac.uk/che/ See their "short courses" on economics at: http://www.york.ac.uk/che/courses/short/

A list of training opportunities in health economics is available at HealthEconomics.com. However, this list may be out of date.
http://www.healtheconomics.com

Pre-conference workshops are offered each June at the Conference of the American Society of Health Economists.
http://healtheconomics.us/
In recent years, these have included workshops on "Economic Evaluation of Drugs, Devices and other Medical Interventions," and "Health Econometrics of Health Cost, Expenditure and Utilization Data." Information on these workshops is found on the pages with conference details.


Publications on cost effectiveness

Read Cost-effectiveness in health and medicine by M.R. Gold and Methods for the economic evaluation of health care programmes by MF Drummond. For more information, visit the "Introduction to Cost-Effectiveness Analysis (CEA)" webpage.