[EQ] Evidence-based Health Economics: what is it and where does it come from?

Complex Problems or Simple Solutions?
Enhancing Evidence-based Economics to Reflect Reality

Chantale Lessard, Canadian Institutes of Health Research (CIHR) Fellow - Department of Health Administration - School of Public Health, Faculty of Medicine University of Montreal - Montreal, Quebec, Canada

Stephen Birch, Professor Department of Clinical Epidemiology and Biostatistics McMaster University Hamilton, Ontario, Canada & School of Community Based Medicine University of Manchester, Manchester, United Kingdom
CHEPA working paper series Paper 09-05 - July 8, 2009
The Centre for Health Economics and policy Analysis (CHEPA)

The final version of this working paper will be published as a chapter in: Donaldson, Shemilt, Mugford, Vale & Marsh (eds) (2010) Evidence-Based Decisions and Economics: Health care, social welfare, education and criminal justice. Blackwell Publishing, Oxford.

Available online [24p.] at: http://www.chepa.org/Libraries/PDFs/WP_09_05.sflb.ashx

 

 ‘……As demands for new health care technologies1 increase in environments of cost-containment, choices must be made about which interventions to fund. Similar problems arise in other sectors as decision-makers struggle to determine the most productive ways of deploying the resources available to them. The evidence-based approach has drawn on economics aimed at providing analytical frameworks to inform decision-making about effectiveness and efficiency of resource use. These frameworks increasingly form the basis for resource allocation decisions.

For example, jurisdictions have adopted formal requirements and guidelines for economic evaluation in health care (1-4). Donaldson and colleagues (5) recognise the need for the application of evidence-based principles in the practice of economic evaluation. However, the importance of adopting evidence-based approaches in health economics is not confined to the economic evaluation of new technologies.

Health economics encompasses a much broader range of influences and constraints on the production of health, illness and recovery in populations (6). Moreover, under an evidence-based approach, the methods and processes used, as well as the principles and assumptions on which they are based, must themselves be compatible with the concepts of economics (5).

 

The evidence-based approach to decision-making draws its foundations from clinical epidemiology. The focus of attention is establishing ‘evidence’ of effectiveness, i.e., providing information on whether a technology works or not (7). This has lead to the development and use of research methods which devalue the complexity of social reality and exclude the consideration of context (8). As a result, the research answers questions about whether the intervention ‘works’ on average in the sample of the population selected for study….”

 

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