Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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The Primary Process and Key Concepts of Economic Evaluation in Healthcare

  • Kim, Younhee (Department of Social Medicine, Inha University College of Medicine) ;
  • Kim, Yunjung (Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency) ;
  • Lee, Hyeon-Jeong (Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency) ;
  • Lee, Seulki (Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency) ;
  • Park, Sun-Young (VIAplus) ;
  • Oh, Sung-Hee (BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University) ;
  • Jang, Suhyun (College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University) ;
  • Lee, Taejin (Department of Public Health Science, Graduate School of Public Health, Seoul National University) ;
  • Ahn, Jeonghoon (Department of Health Convergence, Ewha Womans University) ;
  • Shin, Sangjin (Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency)
  • Received : 2022.04.29
  • Accepted : 2022.07.20
  • Published : 2022.09.30
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Abstract

Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

Keywords

Acknowledgement

This study was supported by National Evidence-based Healthcare Collaborating Agency (NR20-001; NR21-001).

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