Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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Critical Review of health care economic evaluation methodology : With a special reference to study design and cost estimation

보건의료 경제성 평가 방법론 고찰 -연구 설계와 비용 추정을 중심으로-

  • ;
  • Brouwer WBF (Department of Health Policy and Management, Institute for Medical Technology, Assessment, Erasmus University Rotterdam, The Netherland) ;
  • ;
  • 이건세 (건국대학교 의과대학 예방의학교실) ;
  • ;
  • 이상일 (울산대학교 의과대학 예방의학교) ;
  • 구혜원 (건국대학교 의과대학 예방의학교실)
  • Published : 2004.06.01
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Abstract

Cost containment has become high political issues since financial crisis of the Korean Health Insurance fund in 2000. Korean Government has developed and implemented several measures to reduce the pharmaceutical expenditures. Pharmaceutical economic evaluation can be a tool in decision to allocate scare resource efficiently. In order to increase the quality of economic evaluation for pharmaceuticals, the Korean Health Insurance Review Agency(HIRA) is considering the development of a guideline for economic evaluation. It mandates that pharmaceutical companies could submit the result of an economic evaluation when demanding reimbursement of new pharmaceutical drugs. The purpose of this study is to provide a critical review of the economic evaluations of health care technologies published in the Korean context whether they have been performed according to current guidelines and therefore whether their results are directly useful for decision making. We found there exist important problems and deviation from, good practice' both in the general features of the studies, like the study design and perspective, and in terms of cost measurement and valuation. There are needs to develop clear guidelines and to educate and train researchers in performing economic evaluations.

Keywords

References

  1. 김창엽, 이진석, 강길원, 김윤. 의료보험 환자가 병원진료시 부담하는 본인부담 크기. 한국보건행정학회지 1999;9(4):1-14.
  2. 이태진. 약물경제성 평가 현황과 제도 도입방향. 주요 외국의 '약물경제성평가 및 성과연구' 현황과 시사점. 2003.
  3. Brouwer WB, Koopmanschap MA, Rutten FF. Productivity costs in cost-effectiveness analysis: numerator or denominator: a further discussion. Health Economics 1997 Sep-Oct;6(5):511-4. https://doi.org/10.1002/(SICI)1099-1050(199709)6:5<511::AID-HEC297>3.0.CO;2-K
  4. Commonwealth Department of Health and Ageing. Manual of resource items and their associated costs. Canberra. 2002. Available from http://www.health.gov.au/pbs/ pubs/manual
  5. Davidoff AJ, Powe NR. The role of perspective in defining economic measures for the evaluation of medical technology. International Journal of Technology Assessment in Health Care 1996 Winter;12(1):9-21. https://doi.org/10.1017/S026646230000934X
  6. Drummond MF, Jefferson TO. Guidelines for authors and peer reviewers of economic submissions to the BMJ. British Medical Journal 1996;313(3):275-83. https://doi.org/10.1136/bmj.313.7052.275
  7. Drummond M, O'Brien B, Stoddart G, et al. Methods of Economic Evaluation of Health Care Programmes. 2nd ed. New York:Oxford University Press;1997.
  8. Drummond M and McGuire A (ed). Economic evaluation in health care, merging theory with practice. New York:Oxford University Press;2001.
  9. Elsinga E, Rutten FF. Economic evaluation in support of national health policy: the case of The Netherlands. Social Science and Medicine 1997;45(4):605-20. https://doi.org/10.1016/S0277-9536(96)00400-5
  10. Gold MR, Siegel ES, Russell LB, Weinstein MC. Cost effectiveness in health and medicine. New York:Oxford University Press;1996.
  11. Graves N, Walker D, Raine R, Hutchings A, Roberts JA. Cost data for individual patients included in clinical studies: no amount of statistical analysis can compensate for inadequate costing methods. Health Economics 2002;11(8):735-739. https://doi.org/10.1002/hec.683
  12. Guyatt G, Drummond M, Feeny D, Tugwell P, Stoddart G, Haynes RB, Bennett K, Labelle R. Guidelines for the clinical and economic evaluation of health care technologies. Social Science and Medicine 1986;22(4):393-408. https://doi.org/10.1016/0277-9536(86)90046-8
  13. Halpern MT, McKenna M, Hutton J. Modeling in economic evaluation: an unavoidable fact of life. Health Economics 1998;7(8):741-742. https://doi.org/10.1002/(SICI)1099-1050(199812)7:8<741::AID-HEC389>3.0.CO;2-8
  14. Ham C, Honigsbaum F. Priority setting and rationing health services.In : Saltman RB, Figueras J, Sakellarides S editors. Critical challenges for health care reform in Europe. Philadelphia:Open University Press;1998.
  15. Hoffmann C, Graf von der Schulenburg JM. The influence of economic evaluation studies on decision making. A European survey. The EUROMET group. Health Policy 2000;52(3):179-92. https://doi.org/10.1016/S0168-8510(00)00076-2
  16. Institute of Health Economics. A national list of provincial costs for health care. 1997;8.
  17. Jacobs P, Roos NP. Standard cost lists for healthcare in Canada. Issues in validity and inter-provincial consolidation. Pharmacoeconomics 1999;15(6):551-60. https://doi.org/10.2165/00019053-199915060-00003
  18. Jefferson T, Demicheli V, Vale L. Quality of systematic reviews of economic evaluations in health care. Journal of Amerian Medical Association 2002;287:2809-2812. https://doi.org/10.1001/jama.287.21.2809
  19. Kanavos P, Trueman P, Bosilevac A. Can economic evaluation guidelines improve efficiency in resource allocation? The cases of Portugal, The Netherlands, Finland, and the United Kingdom. International Journal of Technology Assessment in Health Care 2000;16(4):1179-92. https://doi.org/10.1017/S0266462300103216
  20. Kernick D. Costing interventions in primary care. Family Practice 2000;17:6670.
  21. Koopmanschap MA, Rutten FF, van Ineveld BM, van Roijen L. The friction cost method for measuring indirect costs of disease. Journal of Health Economics 1995;14(2):171-89. https://doi.org/10.1016/0167-6296(94)00044-5
  22. Luce BR, Elixhauser A. Estimating costs in the economic evaluation of medical technologies. International Journal of Technology Assessment in Health Care 1990;6(1):57-75. https://doi.org/10.1017/S026646230000893X
  23. OECD. OECD review health care system Korea. 2003.
  24. Oostenbrink JB, Koopmanschap MA, Rutten FF. Standardisation of costs: the Dutch Manual for Costing in economic evaluations. Pharmacoeconomics 2002;20(7):443-54. https://doi.org/10.2165/00019053-200220070-00002
  25. Oostenbrink JB, Buijs-Van der Woude T, van Agthoven M, Koopmanschap MA, Rutten FF. Unit costs of inpatient hospital days. Pharmacoeconomics 2003;21(4):263-71. https://doi.org/10.2165/00019053-200321040-00004
  26. Powe NR, Griffiths RI. The clinical-economic trial: promise, problems, and challenges. : Control Clinical Trials 1995;16(6):377-94. https://doi.org/10.1016/S0197-2456(95)00075-5
  27. Rutten F. Economic evaluation and health care decision-making. Health Policy 1996;36(3):215-29. https://doi.org/10.1016/0168-8510(96)00814-7
  28. Severens JL, van der Wilt GJ. Economic evaluation of diagnostic tests. A review of published studies. International Journal of Technology Assessment in Health Care 1999;15(3):480-96. https://doi.org/10.1017/S0266462399153169
  29. Sheldon TA. Problems of using modelling in the economic evaluation of health care. Health Economics 1996;5(1):1-11. https://doi.org/10.1002/(SICI)1099-1050(199601)5:1<1::AID-HEC183>3.0.CO;2-K
  30. Stolk EA, Brouwer WBF, Busschbach JJV. Rationalising rationing: economic and other considerations in the debate about funding of Viagra, Health Policy 2002;59(1):53-63. https://doi.org/10.1016/S0168-8510(01)00162-2
  31. Stone PW, Chapman RH, Sandberg EA, Liljas B, Neumann PJ. Measuring costs in cost-utility analyses. Variations in the literature. International Journal of Technology Assessment in Health Care 2000;16(1):111-24. https://doi.org/10.1017/S0266462300161100
  32. Vissers JM. Health care management modelling: a process perspective. Health Care Management Science 1998;1(2):77-85. https://doi.org/10.1023/A:1019042518494
  33. Zarnke KB, Levine MA, O'Brien BJ. Cost-benefit analyses in the health-care literature: don't judge a study by its label. Journal of Clinical Epidemiology 1997;50(7):813-22. https://doi.org/10.1016/S0895-4356(97)00064-4

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