Measuring and Valuing Health Benefits for Economic Evaluation

Front Cover
There are not enough resources in health care systems around the world to fund all technically feasible and potentially beneficial health care interventions. Difficult choices have to be made, and economic evaluation offers a systematic and transparent process for informing such choices. A key component of economic evaluation is how to value the benefits of health care in a way that permits comparison between health care interventions. In addition, the establishment of the NationalInstitute for Health and Clinical Excellence (NICE) and similar bodies around the world which require cost-effectiveness evidence to be in the form of incremental cost per QALY has resulted in an explosion of theoretical and empirical work in the field. This is the first comprehensive textbookconcerning the measurement and valuation of health benefits for economic evaluation, an area which continues to be a major source of debate.The books addresses the key questions in the measurement and valuation of health, including: the definition of health, the techniques of valuation, who should provide the values, techniques for modelling health state values, the appropriateness of tools in children and vulnerable groups, cross cultural issues, and the problem of choosing the right instrument. The book concludes with a discussion of the way forward in light of the substantial methodological differences, the role of normativejudgements, and where further research is most likely to take this fascinating component of health economics.
 

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Contents

1 The purpose and scope of this book
1
2 Introduction to the measurement and valuation of health
7
what should be valued?
37
4 Describing health
55
5 Valuing health
83
6 Modelling health state valuation data
139
7 Using ordinal data to estimate cardinal valuations
159
generic preferencebased measures of health and the alternatives
175
9 Design and analysis of health state valuation data for trial and modelbased economic evaluations
257
10 A QALY is a QALY is a QALYor is it not?
287
an international perspective
299
12 Conclusions
317
Glossary
325
Index
337
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About the author (2007)

John Brazier's main interests are the measurement and valuation of health for economic evaluation, where he has published widely. He is perhaps best known for his work in developing a preference-based measure of health for the SF-36, but more recently has extended these methods to a number ofcondition specific measures. At the same time, he has been pursuing a more critical perspective on preference-based measurement. He has been a member of the Technology Appraisal Committee of the National Institute for Health and Clinical Excellence in England and Wales. He is Associate Editor ofthe journals 'Quality of Life Research' and 'Applied Health Economics and Policy', and is a Member of the International Society for Quality of Life Research Board of Directors. He was awarded the 'Article of the Year Award' from the prestigious International Society of Quality of Life for the paper'Estimation of a preference-based measure of health' from the Journal of Health Economics, 2002. Dr Julie Ratcliffe has 15 years experience in research and teaching health economics and economic evaluation. She has also worked within the pharmaceutical industry and has acted as a consultant toindustry and government. Julie joined the School of Health and Related Research (ScHARR) at the University of Sheffield in January 2003. Her main research interests concern the elicitation of patient and public preferences for health care.Dr Aki Tsuchiya joined ScHARR at the University of Sheffield in September 2000 as a Research Associate and is Reader in Economics and Health Economics. He has a PhD from the Graduate School of Economics, University of Kyoto, Japan. Professor Joshua A Salomon is Assistant Professor of InternationalHealth at Harvard School of Public Health. His research focuses on priority setting in global health, within three main substantive areas: measurement of population health status and health valuations in community surveys; modeling and forecasting of health outcomes and disease burden; andevaluation of the potential impact and cost-effectiveness of health interventions. A major emphasis has been on development of new approaches to data collection and analysis of health measurements, with a particular focus on developing country settings and aging populations. Professor Salomon earneda BA from Harvard College and a PhD in Health Policy and Decision Sciences from Harvard University.

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