1) Why is economic evaluation in healthcare important?
2) Why has economic evaluation been slow to develop in the U.S?
3) Describe the different types of economic evaluation utilized in healthcare.
4) Describe in general the categories of common measurers and tools of economic evaluation in healthcare. (For this question just describe the categories. More detailed questions will follow)
5) Describe the step process of measuring costs.
6) Explain direct and indirect costs.
7) Describe the different types of effectiveness measures.
8) Describe what is meant by quality-of-life measures.
9) Explain the concept of willingness to pay.
a. Report the percentage of US citizens in medical debt and the number of US citizens that file bankruptcy due to medical debt.
b. Explain what YOU think is happening with “willingness to pay” in the US.
c.
10) Describe the process and importance of discounting costs and benefits.
11) Describe how decision trees are utilized in economic evaluations.
12) Describe the concept of sensitivity analysis in economic evaluation.
13) Describe the hierarchy of data source utilized in economic evaluations.
14) Summarize the issues faced in economic evaluations.
Economic evaluation has been relatively slow to develop and gain prominence in the U.S. healthcare system primarily due to structural and cultural factors:
Fragmented System and Fee-for-Service: The U.S. historically operates on a fragmented, multi-payer system heavily focused on fee-for-service (FFS) payment. This model rewards volume (doing more) rather than value (achieving better outcomes efficiently), reducing the incentive for providers to prioritize cost-effectiveness.
Political and Cultural Resistance: There is significant political resistance to the idea of a "centralized" body determining the value of care or rationing services. Concerns about "death panels" or limiting patient choice have historically constrained the government's ability to mandate cost-effectiveness studies.
Lack of Centralized Authority: Unlike many European countries with national health services (which often mandate cost-effectiveness data before approving new drugs/technologies), the U.S. lacks a single, powerful regulatory body responsible for cost-effectiveness reviews that directly tie to national coverage decisions.
Focus on Innovation over Cost: The U.S. system strongly emphasizes rapid access to innovative, often high-cost, technologies and drugs, sometimes viewing cost-containment measures as a barrier to innovation.
Sample Answer
Why is Economic Evaluation in Healthcare Important? 💰
Economic evaluation in healthcare is crucial because it provides a systematic framework for comparing the costs and consequences (health outcomes) of different healthcare interventions (treatments, programs, technologies). Its primary importance lies in optimizing resource allocation. Given that healthcare budgets are finite, these evaluations help decision-makers (governments, hospitals, insurance companies) determine which interventions provide the best value for money, ensuring that scarce resources are used to achieve the maximum possible health gain for the population.