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MGTECON 332/Health Research and Policy 392/Medical Information Science 432: Analysis of Costs, Risks and Benefits of Health Care
Required text:
Methods for the economic evaluation of health care programmes, 3rd ed., by Drummond, Sculpher, Torrance, O'Brien, and Stoddart, Oxford University Press, 2005
Jackson Library: 1 copy on Reserve
Lane Medical Library: RA410.5.D77 2005
Recommended texts:
Cost-Effectiveness in Health and Medicine, by Gold, Siegel, Russell, and Wenstein, Oxford University Press, 1996
Jackson Library: 2 copies on Reserve
Lane Medical Library: RA410.5 .C688 1996
Health Economics, 4th ed., ed by Phelps, Addison-Wesley, 2009.
Jackson Library: 1 copy on Reserve
Reading assignments by lecture topics:
- Introduction
- Basic Approach to Cost Effectiveness and Cost-Benefit Analysis in Health Care
- Decision Analysis
- Introduction to Markov and Related Modeling Techniques
- Valuing Output I: Quality-Adjusted Life Years (QALYs), Patient Preferences, and Outcomes
- Valuing Output II: Human Capital and Contingent Valuation
- Cost Finding
- Evaluating Efficacy
- Diagnosis of Coronary Artery Disease
- Probabilistic Sensitivity Analysis and Modeling
- HIV Detection Strategies
- Vaccine Development: Value and Incentives
- Economics of Genomics
- Evaluation in Kaiser-Permanente
- Pharmaceutical Industry Perspective on CEA
Related Link: Stanford Health Care Club
Introduction
Fuchs VR, Garber AM. The new technology assessment. New England Journal of Medicine, 1990; 323:673-677 (Syllabus, 5pp.).
Drummond: Chapters 1 and 2, pp. 1-26 (Text, 26 pp.)
Singer P. Why We Must Ration Health Care. The New York Times, July 19 2009 (Online, 8pp.)
Optional Reading:
Garber, AM, Skinner, J: Is American Health Care Uniquely Inefficient? Journal of Economic Perspectives, 2008; 22(4): 27-50. View article ![]()
Gold: Chapter 1, pp. 3-24 (Text, 21 pp.)
Basic Approach to Cost Effectiveness and Cost-Benefit Analysis in Health Care
Enthoven AC, Garber AM: Economic Analysis of Health and Medical Technologies ad Practices, and other Public Programs. An Overview Outline. (Syllabus, 27 pp.)
Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB. Recommendations of the Panel on Cost-Effectiveness in Health and Medicine. Journal of the American Medical Association, 1996; 276: 1253-1258 (Syllabus, 6 pp.)
Drummond: Chapter 3, sections 3.1-3.3 pp. 27-48 (Text, 22 pp.), Chapter 5, pp. 103-136 (Text, 34 pp.), Chapter 6, sections 6.1-6.2, pp. 137-147 (Text, 11 pp.) and Chapter 7, section 7.1, pp. 211-215 (text, 5 pp.)
Gold: Chapter 8, pp. 247-271 (Text, 25 pp.)
Optional reading:
Garber AM. Advances in cost-effectiveness analysis of health interventions, Chapter 4, pp. 181-221, in Culyer AJ, Newhouse JP, eds., Handbook of Health Economics, Volume 1A, Amsterdam: Elsevier Science B.V., 2000. (On reserve, 40 pp.)
* This chapter gives an overview of recent developments in cost-effectiveness analysis. It includes technical material written at the graduate economics level.
Decision Analysis
Owens DK, Soc HC: Biomedical Decision Making: Probabilistic Clinical Reasoning. Chapter 3, pages 80-132 in Shortliffe and Cimino, eds., Biomedical Informatics: Computer Applications in Health Care and Biomedicine, 3rd edition. New York: Springer, 2006 (Syllabus, 52 pp.)
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Sculpher M, Fenwick E, Claxton K. Assessing Quality in Decision Analytic Cost-Effectiveness Models: A Suggested Framework and Example of Application. PharmacoEconomics, 2000; 17(5): 461-477.
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Optional reading:
Detsky, AS, Naglie G, Krahn MD, Naimark D, Redelmeier DA. Primer on medical decision analysis: Part 1- Getting started. Medical Decision Making, 1997; 17:123-125.
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Detsky AS, Naglie G, Krahn MD, Redelmeier DA, Naimark D. Primer on medical decision analysis: Part 2- Building a tree. Medical Decision Making, 1997; 17:126-135.
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Naglie G, Krahn MD, Naimark D, Redelmeier DA, Detsky AS. Primer on medical decision analysis: Part 3- Estimating probabilities and utilities. Medical Decision Making, 1997; 17:136-141.
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Krahn MD, Naglie G, Naimark D, Redelmeier DA, Detsky AS. Primer on medical decision analysis: Part 4- Analyzing the model and interpreting the results. Medical Decision Making, 1997; 17: 142-151.
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Introduction to Markov and Related Modeling Techniques
Sonnenberg F, Beck R. Markov models in Medical Decision Making: A Practical Guide. Medical Decision Making, 1993; 13 (4): 322-338 (Syllabus, 17 pp.)
Optional reading:
Naimark D, Krahn MD, Naglie G, Redelmeier DA, Detsky AS. Primer on medical decision analysis: Part 5- Working with Markov processes. Medical Decision Making, 1997; 178:152-159.
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Valuing Output I: Quality-Adjusted Life Years (QALYs), Patient Preferences, and Outcomes
Tengs TO, Wallace A. One Thousand Health-Related Quality-of-Life Estimates. Medical Care, 2000; 38(6):583-637.
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Bell CM, Chapman RH, Stone PW, Sadberg EA, Neuman PJ. An off-the-shelf help list: a comprehensive catalog of preference scores from published cost-utility analysis. Medical Decision Making, 2001; 21:288-294.
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Drummond: Chapter 6, Sections 6.3 to en of chapter, p. 147-196 (Text, 50 pp.)
* After reading this chapter, please examine Tables 6.10 and6.11 and read the instructions for determining your Health Utilities Index mark3 classification score. At noon the day before class please measure your quality of well being.
Optional reading:
Gold: Chapter 4,pp. 82-134 (Text, 52 pp.)
Valuing Output II
Drummond: Chapter 7, review section 7.1 and read the rest of the chapter, pp. 211-240 (Text, 30 pp.)
Optional reading:
Gold: Chapter 2, pp. 25-53 (Text, 28 pp.)
Schelling TC: The life you save may be your own. In SB Chase (Ed.) Problems in Public Expenditure Analysis, Brookings, Washington, 1968 (On reserve, 35 pp.)
Cost Finding
Drummond: Chapter 4, pp. 55-101 (Text, 47 pp.)
Optional reading:
Gold: Chapter 6, pp. 176-213 (Text, 37 pp.)
Evaluating Efficacy
U.S. Preventive Services Task Force, Guide to Clinical Preventive Services, 2nd edition, 1996, Methodology, pp. xxxix-lx (Syllabus, 9 pp.) Online version of updated methodology (Excerpt in syllabus, 14 pp.)
Enthoven AC: Part I--Overview of Technology Assessment and Research Designs, and Part II--An Introductory Overview of Selected Research Designs (Syllabus, 32 pp.)
Optional reading:
Phelps C. The methodologic foundations of studies of the appropriateness of medical care. New England Journal of Medicine, 1993; 329:1241-5.
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Gold: Chapter 3, p. 54-81 (Text, 27 pp.)
Diagnosis of Coronary Artery Disease
Garber AM, Solomon NA. Cost-effectiveness of alternative test strategies for the diagnosis of coronary artery disease. Annals of Internal Medicine, 1999; 130(9):719-728.
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Probabilistic Sensitivity Analysis and Modeling
Briggs AH, Goeree R, Blackhouse G, and O'Brien, B. Probabilistic Analysis of Cost-Effectiveness Models: Choosing between Treatment Strategies for Gastroesophageal Reflux Disease. Medical Decision Making, 2002; 22: 290-308
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Claxton K, Sculpher M, McCabe C, Briggs A, Akehurst R, Buxton M, Brazier J and O'Hagan T. Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra. Health Economics, 2005; 14: 339-347
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Optional reading:
Fenwick E, Claxton K, Sculpher M. Representing uncertainty: the role of cost-effectiveness acceptability curves. Health Economics, 2001 Dec;10(8):779-8
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HIV Detection Strategies
Sanders GD, Bayoumi AM, SundaramV, Bilir SP, Neukermans CP, Rydzak CE, Douglass LR, Lazzeroni LC, Holodniy M, Owens DK. Cost effectiveness of screening for HIV in the era of highly active antiretroviral therapy. New England Journal of Medicine, 2005; 352(6): 570-85
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Owens DK, Harris RA, Scott P, Nease RF: Screening surgeons for HIV infection: a cost-effectiveness analysis. Annals of International Medicine, 1995; 122:641-652
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Optional reading:
Qaseem A, Snow V, Shekelle P, Hopkins R, Owens DK, for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Screening for HIV in health care settings: A guidance statement from the American College of Physicians. Annals of Internal Medicine 2009; 150:125-131
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Vaccine Development: Value and Incentives
43 Ways to Save the World. The Economist, July 2 2005; 376(8433): 69-70
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Economics of Genomics
Evaluation in Kaiser-Permanente
Levine S., Campen D., Millares M., Barrueta A. Kaiser Permanente's prescription drug benefit. Health Affairs, 2000; 19(2): 185-190
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Garber AM, Cost-effectiveness and evidence evaluation as criteria for coverage policy. Health Affairs, 2004; Web Exclusive W4-284-W4-296
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Pharmaceutical Industry Perspective on CEA
Optional reading:
Sharpe P, Keelin T. How SmithKline Beecham Makes Better Resource-Allocation Decisions. Harvard Business Review, March-April 1998:76(2):45-57
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Pharmacoeconomic Guidelines Around the World
From International Society for Pharmacoeconomics & Outcomes Research.
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