HERC: Cost-Effectiveness Analysis with VA Data Seminar Series
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Cost-Effectiveness Analysis with VA Data Seminar Series


The purpose of the cost-effectiveness analyses with VA data seminar series is to introduce researchers to conducting cost-effectiveness analyses and budget impact analyses of healthcare interventions in VA. Cost-effectiveness and budget impact analyses are two types of decision analysis techniques. Cost-effectiveness is a method to assess the comparative impact of different interventions on cost and health effect. The information produced by a cost-effectiveness analysis can be used by decision makers in allocating scarce healthcare resources to interventions that provide the most health benefit per dollar spent. Budget impact analyses serve as a complement to cost-effectiveness analyses. In the likely event that an intervention is cost-effective but not cost-saving, a budget impact analysis can provide decision makers with estimates of the budget and sub-budget impacts of the intervention. Therefore, a cost-effectiveness analysis is used to determine whether an intervention is high-value and a budget impact analysis is used to determine whether an intervention is affordable. This HERC seminar series provides an overview of the decision analysis landscape and methods to operationalize cost-effectiveness and budget impact analyses.

Target audience: This seminar series is primarily designed for researchers who would like an introduction to methods of cost-effectiveness analysis and budget impact analysis as applied to health services and medicine.

Schedule and registration details: The next Cost Effectiveness Analysis with VA Data seminar series will take place in 2022. Links to slides and videos from previous seminars are included below.

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2020 Cost-Effectiveness Analysis with VA Data Seminar Series
January 21, 2020
Recommendations for the Conduct of Cost-Effectiveness Analysis from the Second Panel on Cost-Effectiveness Analysis in Health and Medicine
Doug Owens, M.D., M.S. | Slides and video

This presentation will summarize the main recommendations about how to design and conduct a cost-effectiveness analysis based on guidelines from the Second Panel on Cost-Effectiveness in Health and Medicine, released in the fall of 2016. In a major change from prior recommendations, the Second Panel recommends the use of two perspectives in cost-effectiveness analysis: the health care sector perspective and the societal perspective, including education and the criminal justice systems. To aid in transparency, the Panel also recommends the use of public protocols that outline how an analysis will be conducted.

January 29, 2020
An Overview of Decision Analysis
Liam Rose, Ph.D. | Slides and video

This lecture provides 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.

February 5, 2020
Estimating the Cost of an Intervention
Clara Dismuke-Greer, Ph.D. | Slides and 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 12, 2020
Pharmaceutical Costs for Cost-Effectiveness Analysis
Mark Bounthavong, Pharm.D., Ph.D. | Slides and video

Determining costs of pharmaceuticals is an important step for cost-effectiveness analysis. In 2016, the Second Panel in Cost-Effectiveness in Health and Medicine recommended that the Federal Supply Schedule (FSS) price for pharmaceuticals should be used in cost-effectiveness analysis research. However, cost-effectiveness analyses continue to use a variety of available sources for pharmaceutical costs. In this presentation, we will examine the different types of pharmaceutical costs available such as the Average Wholesale Price (AWP), Wholesale Acquisition Costs (WAC), Federal Supply Schedule (FSS), and Actual Acquisition Cost (AAC). We will discuss their advantage and disadvantages, as well as, learn about methods to determine the most accurate pharmaceutical costs for cost-effectiveness analyses.

February 26, 2020
VA Costs: HERC versus MCA
Jean Yoon, Ph.D. | Slides and 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.

March 4, 2020
Medical Decision Making and Decision Analysis
Jeremy Goldhaber-Fiebert, Ph.D. | Slides and video

The 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 11, 2020
Introduction to Effectiveness, Patient Preferences, and Utilities
Josephine Jacobs, Ph.D. | Slides and video

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

March 25, 2020
CEA Alongside a Clinical Trial
Todd Wagner, Ph.D. | Slides and video

Conducting a cost-effectiveness analysis alongside a randomized trial is possible, and with proper planning (and some luck) this approach offers some unique opportunities for health economics research. This presentation describes the steps needed for such an analysis and then walks through the analysis using an example from a multi-site surgical study.

April 8, 2020
Budget Impact Analysis
Todd Wagner, Ph.D. | Slides and 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.

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:

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: https://www.york.ac.uk/che/courses/.

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

Pre-conference workshops are offered each June at the Conference of the American Society of Health Economists.
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.