The main objectives of this module are:

 

After completion of the course, students are able to

1. define efficiency in the context of health care based on current economic theory
2. explain how a cost-effectiveness analysis needs to be designed, executed and analyzed
3. apply / perform a critical appraisal on a set of cost-effectiveness analyses
4. distinguish (analysis) between several decision rules to infer economic ‘added value’
5. design (synthesis) a cost-effectiveness analysis
6. evaluate cost in a CEA
7. evaluate QALYs in a CEA
8. evaluate (evaluation) a cost-effectiveness analysis
9. understand the concept of time value of money and health
10. perform an economic evaluation by integrating the knowledge above into an incremental cost-effectiveness ratio (ICER) dealing with uncertainty and interpreting the results in terms of its meaning for health care decision making

The module 

Governments are seeking information on the efficiency of health care strategies in order to rationalize their policies and increase the efficiency of the health care sector. Similarly, information on the cost-effectiveness of strategies for diagnosis and treatment is continuously gaining ground in daily medical practice and is incorporated into recommendations and guidelines for the efficient provision of health care.
Cost-effectiveness analyses (CEAs) are performed to identify the costs and effectiveness of new health care technologies and compare them to the costs and effectiveness of their first best alternative. Such analyses use an incremental approach on gathering information about costs and effects and finally establishing the surplus value of a ‘new’ technology. The aim of cost-effectiveness analysis is to provide information that enables rationalized decision making on the unavoidable allocation of scarce resources in health care. In the Netherlands, but also in other Western countries, there is consensus, laid down in Directives, as to how a CEA should be performed. CEA is based on 'economic thinking'.
This module provides an understanding of the basic principles of cost-effectiveness analysis and its embedding in economic theory. The module then develops the student's understanding of the various approaches to measure economic surplus (cost-minimization-, cost-effectiveness-, cost- utility-, cost-benefit analysis) together with their strengths and weaknesses. An in-depth assessment is made of the different features of CEA in health care and the development of critical appraisal skills. The context of researching the cost-effectiveness question will be addressed broadly focusing           on CEA alongside clinical studies (cohorts as well as trials) and an introduction to CEA based on decision analytical modelling. The emphasis will be on empirical cost-effectiveness analyses, i.e., how to measure costs and Quality Adjusted Life Years (QALYs) in a prospective clinical study. By the end  of this module, the student will be able to demonstrate an ability to critically appraise key issues of cost-effectiveness analysis, benefit valuation and costing methods. In terms of applied research   skills, students will be able to design a cost-effectiveness analysis and up to a certain degree conduct one. Also computer skills related to the performance of a cost-effectiveness analysis will be developed.
The module is assessed through one group assignment (30%) and an individual exam (70%). The assignment specifically tests the critical appraisal skill of the students. The exam is based on the core text book Drummond et al., 2015, 4th edition.