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Open AccessArticle

Dengue Vaccines: A Perspective from the Point of View of Intellectual Property

by

Claudimar Pereira Da Veiga

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Cássia Rita Pereira Da Veiga

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Jansen Maia Del Corso

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Wesley Vieira Da Silva

Int. J. Environ. Res. Public Health 2015, 12(8), 9454-9474; https://doi.org/10.3390/ijerph120809454 - 12 Aug 2015

Cited by 7 | Viewed by 5487

Abstract

Dengue is a serious infectious disease and a growing public health problem in many tropical and sub-tropical countries. To control this neglected tropical disease (NTD), vaccines are likely to be the most cost-effective solution. This study analyzed dengue vaccines from both a historical [...] Read more.

Dengue is a serious infectious disease and a growing public health problem in many tropical and sub-tropical countries. To control this neglected tropical disease (NTD), vaccines are likely to be the most cost-effective solution. This study analyzed dengue vaccines from both a historical and longitudinal perspective by using patent data, evaluating the geographic and time coverage of innovations, the primary patent holders, the network of cooperation and partnership for vaccine research and development (R & D), the flow of knowledge and the technological domain involved. This study can be seen as an example of the use of patent information to inform policy discussions, strategic research planning, and technology transfer. The results show that 93% of patents were granted since 2000, the majority belonging to the United States and Europe, although the share of patents from developing countries has increased. Unlike another NTDs, there is great participation of private companies in R & D of dengue vaccines and partnerships and collaboration between public and private companies. Finally, in this study, the main holders showed high knowledge absorption and generated capabilities. Therefore, this issue suggests that to overcome the difficulty of translational R & D it is necessary to stimulate the generation of knowledge and relevant scientific research, to enable the productive sector to have the capacity to absorb knowledge, to turn it into innovation, and to articulate partnerships and collaboration. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessArticle

The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China

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Int. J. Environ. Res. Public Health 2015, 12(8), 9330-9341; https://doi.org/10.3390/ijerph120809330 - 10 Aug 2015

Cited by 16 | Viewed by 4907

Abstract

Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the [...] Read more.

Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters’ willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters’ payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters’ general practitioners using contractual service supply cost. Methods: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60–85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox’s proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. Results: More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox’s proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. Conclusions: The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However, people are willing to pay less than half of the current personal financing of cooperative medical insurance of urban and rural residents. Education level, family per capita income, and self-reported health status are the main factors affecting the cost sharing intention for general practitioners using contract service supply. According to the existing situation of different empty nesters, it is important to perfect the design of general practitioners using a contractual service policy system, according to differentiated personal financing levels. Full article

(This article belongs to the Special Issue Health Economics)

Open AccessArticle

Measuring the Value of Mortality Risk Reductions in Turkey

by

Cem Tekeşin

and

Shihomi Ara

Int. J. Environ. Res. Public Health 2014, 11(7), 6890-6922; https://doi.org/10.3390/ijerph110706890 - 04 Jul 2014

Cited by 9 | Viewed by 7758

Abstract

The willingness to pay (WTP) for mortality risk reduction from four causes (lung cancer, other type of cancer, respiratory disease, traffic accident) are estimated using random parameter logit model with data from choice experiment for three regions in Turkey. The value of statistical [...] Read more.

The willingness to pay (WTP) for mortality risk reduction from four causes (lung cancer, other type of cancer, respiratory disease, traffic accident) are estimated using random parameter logit model with data from choice experiment for three regions in Turkey. The value of statistical life (VSL) estimated for Afsin-Elbistan, Kutahya-Tavsanli, Ankara and the pooled case are found as 0.56, 0.35, 0.46 and 0.49 million Purchasing Power Parity (PPP) adjusted 2012 US dollars (USD). Different types of risk cause different VSL estimates and we found the lung cancer premium of 213% against traffic accident. The effects of one-year-delayed provision of risk-reduction service are the reduction of WTP by 482 TL ($318 in PPP adjusted USD) per person on average, and the disutility from status-quo (zero risk reduction) against alternative is found to be 891 TL ($589 in PPP adjusted USD) per person on average. Senior discounts of VSL are partially determined by status-quo preference and the amount of discount decreases once the status-quo bias is removed. The peak VSL is found to be for the age group 30–39 and the average VSL for the age group is 0.8 million PPP adjusted USD). Turkey’s compliance to European Union (EU) air quality standard will cause welfare gains of total 373 million PPP adjusted USD for our study areas in terms of reduced number of premature mortality. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessArticle

The Impact of Health Insurance Programs on Out-of-Pocket Expenditures in Indonesia: An Increase or a Decrease?

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Int. J. Environ. Res. Public Health 2013, 10(7), 2995-3013; https://doi.org/10.3390/ijerph10072995 - 18 Jul 2013

Cited by 43 | Viewed by 11271

Abstract

We used panel data from the Indonesian Family Life Survey to investigate the impact of health insurance programs on reducing out-of-pocket expenditures. We employed three linear panel data models, two of which accounted for endogeneity: pooled ordinary least squares (OLS), pooled two-stage least [...] Read more.

We used panel data from the Indonesian Family Life Survey to investigate the impact of health insurance programs on reducing out-of-pocket expenditures. We employed three linear panel data models, two of which accounted for endogeneity: pooled ordinary least squares (OLS), pooled two-stage least squares (2SLS) for instrumental variable (IV), and fixed effects (FE). The study revealed that two health insurance programs had a significantly negative impact on out-of-pocket expenditures by using IV estimates. In the IV model, Askeskin decreased out-of-pocket expenditures by 34% and Askes by 55% compared with non-Askeskin and non-Askes, respectively, while Jamsostek was found to bear a nonsignificant effect on out-of-pocket expenditures. In the FE model, only Askeskin had a significant negative effect with an 11% reduction on out-of-pocket expenditures. This study showed that two large existing health insurance programs in Indonesia, Askeskin and Askes, effectively reduced household out-of-pocket expenditures. The ability of programs to offer financial protection by reducing out-of-pocket expenditures is likely to be a direct function of their benefits package and co-payment policies. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessArticle

Assessing Local Communities’ Willingness to Pay for River Network Protection: A Contingent Valuation Study of Shanghai, China

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Int. J. Environ. Res. Public Health 2012, 9(11), 3866-3882; https://doi.org/10.3390/ijerph9113866 - 26 Oct 2012

Cited by 50 | Viewed by 7762

Abstract

River networks have experienced serious degradation because of rapid urbanization and population growth in developing countries such as China, and the protection of these networks requires the integration of evaluation with ecology and economics. In this study, a structured questionnaire survey of local [...] Read more.

River networks have experienced serious degradation because of rapid urbanization and population growth in developing countries such as China, and the protection of these networks requires the integration of evaluation with ecology and economics. In this study, a structured questionnaire survey of local residents in Shanghai (China) was conducted in urban and suburban areas. The study examined residents’ awareness of the value of the river network, sought their attitude toward the current status, and employed a logistic regression analysis based on the contingent valuation method (CVM) to calculate the total benefit and explain the socioeconomic factors influencing the residents’ willingness to pay (WTP). The results suggested that residents in Shanghai had a high degree of recognition of river network value but a low degree of satisfaction with the government’s actions and the current situation. The study also illustrated that the majority of respondents were willing to pay for river network protection. The mean WTP was 226.44 RMB per household per year. The number of years lived in Shanghai, the distance from the home to the nearest river, and the amount of the bid were important factors that influenced the respondents’ WTP. Suggestions for comprehensive management were proposed for the use of policy makers in river network conservation. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessArticle

On Measurement of Avoidable and Unavoidable Cost of Alcohol: An Application of Method for Estimating Costs Due To Prior Consumption

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Int. J. Environ. Res. Public Health 2010, 7(7), 2881-2895; https://doi.org/10.3390/ijerph7072881 - 16 Jul 2010

Cited by 12 | Viewed by 12969

Abstract

This study estimates the avoidable and unavoidable costs of alcohol-related, liver cirrhosis inpatient care, controlling for the lag structure and period of decline in disease risk. Lag structures with different lengths are applied to the exposure to risk from alcohol consumption, which allows [...] Read more.

This study estimates the avoidable and unavoidable costs of alcohol-related, liver cirrhosis inpatient care, controlling for the lag structure and period of decline in disease risk. Lag structures with different lengths are applied to the exposure to risk from alcohol consumption, which allows for differentiation between avoidable and unavoidable cases due to prior consumption. A lag length of 20 (men) and 23 (women) years (expected remaining life years) gives a total cost of 592 million SEK. Given alcohol consumption is reduced to zero, 72% of cost could potentially be avoided. It is important to account for the length and structure of the risk decline following a consumption change as this substantially affects the estimates. Full article

(This article belongs to the Special Issue Health Economics)

Open AccessArticle

Cigarette Smoking in Indonesia: Examination of a Myopic Model of Addictive Behaviour

by

Budi Hidayat

and

Hasbullah Thabrany

Int. J. Environ. Res. Public Health 2010, 7(6), 2473-2485; https://doi.org/10.3390/ijerph7062473 - 04 Jun 2010

Cited by 15 | Viewed by 13110

Abstract

Using aggregated panel data taken from three waves of the Indonesian Family Life Survey (1993–2000), this article tests the myopic addiction behaviour of cigarette demand. Sensitivity analysis is done by examining a rational addiction behavior of cigarette demand. The results provide support for [...] Read more.

Using aggregated panel data taken from three waves of the Indonesian Family Life Survey (1993–2000), this article tests the myopic addiction behaviour of cigarette demand. Sensitivity analysis is done by examining a rational addiction behavior of cigarette demand. The results provide support for myopic addiction. The short- and long-run price elasticities of cigarette demand are estimated at −0.28 and −0.73 respectively. Excise taxes are more likely to act as an effective tobacco control in the long-run rather than a major source of government revenue. Full article

(This article belongs to the Special Issue Health Economics)

Open AccessArticle

Alcohol Taxes and Birth Outcomes

by

Ning Zhang

Int. J. Environ. Res. Public Health 2010, 7(5), 1901-1912; https://doi.org/10.3390/ijerph7051901 - 27 Apr 2010

Cited by 11 | Viewed by 11056

Abstract

This study examines the relationships between alcohol taxation, drinking during pregnancy, and infant health. Merged data from the US Natality Detailed Files, as well as the Behavioral Risk Factor Surveillance System (1985–2002), data regarding state taxes on beer, wine, and liquor, a state- [...] Read more.

This study examines the relationships between alcohol taxation, drinking during pregnancy, and infant health. Merged data from the US Natality Detailed Files, as well as the Behavioral Risk Factor Surveillance System (1985–2002), data regarding state taxes on beer, wine, and liquor, a state- and year-fixed-effect reduced-form regression were used. Results indicate that a one-cent ($0.01) increase in beer taxes decreased the incidence of low-birth-weight by about 1–2 percentage points. The binge drinking participation tax elasticity is −2.5 for beer and wine taxes and −9 for liquor taxes. These results demonstrate the potential intergenerational impact of increasing alcohol taxes. Full article

(This article belongs to the Special Issue Health Economics)

Open AccessArticle

Bayesian Variable Selection in Cost-Effectiveness Analysis

by

Miguel A. Negrín

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Francisco J. Vázquez-Polo

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María Martel

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Elías Moreno

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Francisco J. Girón

Int. J. Environ. Res. Public Health 2010, 7(4), 1577-1596; https://doi.org/10.3390/ijerph7041577 - 06 Apr 2010

Cited by 3 | Viewed by 9203

Abstract

Linear regression models are often used to represent the cost and effectiveness of medical treatment. The covariates used may include sociodemographic variables, such as age, gender or race; clinical variables, such as initial health status, years of treatment or the existence of concomitant [...] Read more.

Linear regression models are often used to represent the cost and effectiveness of medical treatment. The covariates used may include sociodemographic variables, such as age, gender or race; clinical variables, such as initial health status, years of treatment or the existence of concomitant illnesses; and a binary variable indicating the treatment received. However, most studies estimate only one model, which usually includes all the covariates. This procedure ignores the question of uncertainty in model selection. In this paper, we examine four alternative Bayesian variable selection methods that have been proposed. In this analysis, we estimate the inclusion probability of each covariate in the real model conditional on the data. Variable selection can be useful for estimating incremental effectiveness and incremental cost, through Bayesian model averaging, as well as for subgroup analysis. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessArticle

The Selection of an Appropriate Count Data Model for Modelling Health Insurance and Health Care Demand: Case of Indonesia

by

Budi Hidayat

and

Subhash Pokhrel

Int. J. Environ. Res. Public Health 2010, 7(1), 9-27; https://doi.org/10.3390/ijerph7010009 - 29 Dec 2009

Cited by 19 | Viewed by 15931

Abstract

We apply several estimators to Indonesian household data to estimate the relationship between health insurance and the number of outpatient visits to public and private providers. Once endogeneity of insurance is taken into account, there is a 63 percent increase in the average [...] Read more.

We apply several estimators to Indonesian household data to estimate the relationship between health insurance and the number of outpatient visits to public and private providers. Once endogeneity of insurance is taken into account, there is a 63 percent increase in the average number of public visits by the beneficiaries of mandatory insurance for civil servants. Individuals' decisions to make first contact with private providers is affected by private insurance membership. However, insurance status does not make any difference for the number of future outpatient visits. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessArticle

Health and Retirement in Europe

by

Ronald Hagan

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Andrew M. Jones

and

Nigel Rice

Int. J. Environ. Res. Public Health 2009, 6(10), 2676-2695; https://doi.org/10.3390/ijerph6102676 - 20 Oct 2009

Cited by 21 | Viewed by 10947

Abstract

We use discrete-time hazard models with internationally comparable data from the full eight waves of the European Community Household Panel (ECHP) to study the relationship between retirement and health in nine European countries. Our results provide new evidence of the relationship of health [...] Read more.

We use discrete-time hazard models with internationally comparable data from the full eight waves of the European Community Household Panel (ECHP) to study the relationship between retirement and health in nine European countries. Our results provide new evidence of the relationship of health shocks to early retirement. The pattern of results across countries reflects international differences in the incentives created by social security systems. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessArticle

The Influence of Socioeconomic and Environmental Determinants on Health and Obesity: A West Virginia Case Study

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Int. J. Environ. Res. Public Health 2009, 6(8), 2271-2287; https://doi.org/10.3390/ijerph6082271 - 19 Aug 2009

Cited by 30 | Viewed by 16600

Abstract

A recursive system of ordered self assessed health together with BRFSS data were used to investigate health and obesity in the Appalachian state of West Virginia. Implications of unobserved heterogeneity and endogeneity of lifestyle outcomes on health were investigated. Obesity was found to [...] Read more.

A recursive system of ordered self assessed health together with BRFSS data were used to investigate health and obesity in the Appalachian state of West Virginia. Implications of unobserved heterogeneity and endogeneity of lifestyle outcomes on health were investigated. Obesity was found to be an endogenous lifestyle outcome associated with impaired health status. Risk of obesity is found to increase at a decreasing rate with per capita income and age. Intervention measures which stimulate human capital development, diet-disease knowledge and careful land use planning may improve health and obesity outcomes in Appalachia in particular and rural America in general. Full article

(This article belongs to the Special Issue Health Economics)

Review

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Open AccessReview

Potential Transferability of Economic Evaluations of Programs Encouraging Physical Activity in Children and Adolescents across Different Countries—A Systematic Review of the Literature

by

Katharina Korber

Int. J. Environ. Res. Public Health 2014, 11(10), 10606-10621; https://doi.org/10.3390/ijerph111010606 - 15 Oct 2014

Cited by 9 | Viewed by 5291

Abstract

Physical inactivity is an increasing problem. Owing to limited financial resources, one method of getting information on the cost-effectiveness of different types of prevention programs is to examine existing programs and their results. The aim of this paper is to give an overview [...] Read more.

Physical inactivity is an increasing problem. Owing to limited financial resources, one method of getting information on the cost-effectiveness of different types of prevention programs is to examine existing programs and their results. The aim of this paper is to give an overview of the transferability of cost-effectiveness results of physical activity programs for children and adolescents to other contexts. Based on a systematic review of the literature, the transferability of the studies found was assessed using a sub-checklist of the European Network of Health Economic Evaluation Databases (EURONHEED). Thirteen studies of different physical activity interventions were found and analyzed. The results for transferability ranged from “low” to “very high”. A number of different factors influence a program’s cost-effectiveness (i.e., discount rate, time horizon, etc.). Therefore, transparency with regard to these factors is one fundamental element in the transferability of the results. A major point of criticism is that transferability is often limited because of lack of transparency. This paper is the first to provide both an overview and an assessment of transferability of economic evaluations of existing programs encouraging physical activity in children and adolescents. This allows decision makers to gain an impression on whether the findings are transferable to their decision contexts, which may lead to time and cost savings. Full article

(This article belongs to the Special Issue Health Economics)

Open AccessReview

Economic Evaluation of Lifestyle Interventions for Preventing Diabetes and Cardiovascular Diseases

by

Sanjib Saha

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Ulf-G Gerdtham

and

Pia Johansson

Int. J. Environ. Res. Public Health 2010, 7(8), 3150-3195; https://doi.org/10.3390/ijerph7083150 - 09 Aug 2010

Cited by 88 | Viewed by 15351

Abstract

Lifestyle interventions (i.e., diet and/or physical activity) are effective in delaying or preventing the onset of diabetes and cardiovascular disease. However, policymakers must know the cost-effectiveness of such interventions before implementing them at the large-scale population level. This review discusses various [...] Read more.

Lifestyle interventions (i.e., diet and/or physical activity) are effective in delaying or preventing the onset of diabetes and cardiovascular disease. However, policymakers must know the cost-effectiveness of such interventions before implementing them at the large-scale population level. This review discusses various issues (e.g., characteristics, modeling, and long-term effectiveness) in the economic evaluation of lifestyle interventions for the primary and secondary prevention of diabetes and cardiovascular disease. The diverse nature of lifestyle interventions, i.e., type of intervention, means of provision, target groups, setting, and methodology, are the main obstacles to comparing evaluation results. However, most lifestyle interventions are among the intervention options usually regarded as cost-effective. Diabetes prevention programs, such as interventions starting with targeted or universal screening, childhood obesity prevention, and community-based interventions, have reported favorable cost-effectiveness ratios. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessReview

Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

by

Olga Skriabikova

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Milena Pavlova

and

Wim Groot

Int. J. Environ. Res. Public Health 2010, 7(6), 2708-2725; https://doi.org/10.3390/ijerph7062708 - 23 Jun 2010

Cited by 16 | Viewed by 10825

Abstract

This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee) or indirectly as a level of deductibles and/or co-insurance defined [...] Read more.

This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee) or indirectly as a level of deductibles and/or co-insurance defined by the insurance coverage. The paper also discusses the relevance of these models for the assessment of patient payment policies. For this purpose, a systematic literature review is carried out. In total, 46 relevant publications were identified. These publications are classified into categories based on their general approach to demand modeling, specifications of data collection, data analysis, and main empirical findings. The analysis indicates a rising research interest in the empirical micro-level models of demand for out-patient physician services that incorporate the size of patient payment. Overall, the size of patient payments, consumer socio-economic and demographic features, and quality of services provided emerge as important determinants of demand for out-patient physician services. However, there is a great variety in the modeling approaches and inconsistencies in the findings regarding the impact of price on demand for out-patient physician services. Hitherto, the empirical research fails to offer policy-makers a clear strategy on how to develop a country-specific model of demand for out-patient physician services suitable for the assessment of patient payment policies in their countries. In particular, theoretically important factors, such as provider behavior, consumer attitudes, experience and culture, and informal patient payments, are not considered. Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes. Full article

(This article belongs to the Special Issue Health Economics)

Open AccessReview

Outcome Measurement in Economic Evaluations of Public Health Interventions: a Role for the Capability Approach?

by

Paula K. Lorgelly

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Kenny D. Lawson

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Elisabeth A.L. Fenwick

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Andrew H. Briggs

Int. J. Environ. Res. Public Health 2010, 7(5), 2274-2289; https://doi.org/10.3390/ijerph7052274 - 06 May 2010

Cited by 91 | Viewed by 14970

Abstract

Public health interventions have received increased attention from policy makers, and there has been a corresponding increase in the number of economic evaluations within the domain of public health. However, methods to evaluate public health interventions are less well established than those for [...] Read more.

Public health interventions have received increased attention from policy makers, and there has been a corresponding increase in the number of economic evaluations within the domain of public health. However, methods to evaluate public health interventions are less well established than those for medical interventions. Focusing on health as an outcome measure is likely to underestimate the impact of many public health interventions. This paper provides a review of outcome measures in public health; and describes the benefits of using the capability approach as a means to developing an all encompassing outcome measure. Full article

(This article belongs to the Special Issue Health Economics)

Open AccessReview

Economic Evaluation and Transferability of Physical Activity Programmes in Primary Prevention: A Systematic Review

by

Silke B. Wolfenstetter

and

Christina M. Wenig

Int. J. Environ. Res. Public Health 2010, 7(4), 1622-1648; https://doi.org/10.3390/ijerph7041622 - 09 Apr 2010

Cited by 19 | Viewed by 9584

Abstract

This systematic review aims to assess the characteristics of, and the clinical and economic evidence provided by, economic evaluations of primary preventive physical exercise interventions, and to analyse their transferability to Germany using recommended checklists. Fifteen economic evaluations from seven different countries met [...] Read more.

This systematic review aims to assess the characteristics of, and the clinical and economic evidence provided by, economic evaluations of primary preventive physical exercise interventions, and to analyse their transferability to Germany using recommended checklists. Fifteen economic evaluations from seven different countries met eligibility criteria, with seven of the fifteen providing high economic evidence in the special country context. Most of the identified studies conclude that the investigated intervention provide good value for money compared with alternatives. However, this review shows a high variability of the costing methods between the studies, which limits comparability, generalisability and transferability of the results. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessReview

What is Learned from Longitudinal Studies of Advertising and Youth Drinking and Smoking? A Critical Assessment

by

Jon P. Nelson

Int. J. Environ. Res. Public Health 2010, 7(3), 870-926; https://doi.org/10.3390/ijerph7030870 - 08 Mar 2010

Cited by 24 | Viewed by 20881

Abstract

This paper assesses the methodology employed in longitudinal studies of advertising and youth drinking and smoking behaviors. These studies often are given a causal interpretation in the psychology and public health literatures. Four issues are examined from the perspective of econometrics. First, specification [...] Read more.

This paper assesses the methodology employed in longitudinal studies of advertising and youth drinking and smoking behaviors. These studies often are given a causal interpretation in the psychology and public health literatures. Four issues are examined from the perspective of econometrics. First, specification and validation of empirical models. Second, empirical issues associated with measures of advertising receptivity and exposure. Third, potential endogeneity of receptivity and exposure variables. Fourth, sample selection bias in baseline and follow-up surveys. Longitudinal studies reviewed include 20 studies of youth drinking and 26 studies of youth smoking. Substantial shortcomings are found in the studies, which preclude a causal interpretation. Full article

(This article belongs to the Special Issue Health Economics)

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Open AccessReview

Health Economic Assessment: A Methodological Primer

by

Steven Simoens

Int. J. Environ. Res. Public Health 2009, 6(12), 2950-2966; https://doi.org/10.3390/ijerph6122950 - 27 Nov 2009

Cited by 68 | Viewed by 14473

Abstract

This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a [...] Read more.

This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments. Full article

(This article belongs to the Special Issue Health Economics)

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Other

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Open AccessReply

Health Economic Assessment: Cost-Effectiveness Thresholds and Other Decision Criteria

by

Steven Simoens

Int. J. Environ. Res. Public Health 2010, 7(4), 1835-1840; https://doi.org/10.3390/ijerph7041835 - 20 Apr 2010

Cited by 16 | Viewed by 8931

Abstract

An article published in this Journal argued that New Zealand does not apply a cost-effectiveness threshold because medicines are funded within a fixed budget and because cost-effectiveness is only one of nine criteria that inform decisions. This Comment has explained that, from a [...] Read more.

An article published in this Journal argued that New Zealand does not apply a cost-effectiveness threshold because medicines are funded within a fixed budget and because cost-effectiveness is only one of nine criteria that inform decisions. This Comment has explained that, from a theoretical perspective, the cost-effectiveness threshold model is not inconsistent with these two arguments. The observed annual variation in incremental cost-effectiveness ratios in New Zealand may originate from yearly differences in new medicines that request reimbursement and in the budget size, and from the fact that decision makers take into account other decision criteria in addition to cost-effectiveness. Full article

(This article belongs to the Special Issue Health Economics)

Open AccessCommentary

Comments on “Simoens, S. Health Economic Assessment: A Methodological Primer. Int. J. Environ. Res. Public Health 2009, 6, 2950-2966”—New Zealand in Fact Has No Cost-Effectiveness Threshold

by

Scott Metcalfe

and

Rachel Grocott

Int. J. Environ. Res. Public Health 2010, 7(4), 1831-1834; https://doi.org/10.3390/ijerph7041831 - 20 Apr 2010

Cited by 11 | Viewed by 11305

Abstract

The Journal recently incorrectly ascribed cost-effectiveness thresholds to New Zealand, alongside other countries. New Zealand has no such thresholds when deciding the funding of pharmaceuticals. As we fund pharmaceuticals within a fixed budget, and cost-effectiveness is only one of nine decision criteria used [...] Read more.

The Journal recently incorrectly ascribed cost-effectiveness thresholds to New Zealand, alongside other countries. New Zealand has no such thresholds when deciding the funding of pharmaceuticals. As we fund pharmaceuticals within a fixed budget, and cost-effectiveness is only one of nine decision criteria used to inform decisions, thresholds cannot be inferred or calculated. Thresholds inadequately account for opportunity cost and affordability, and are incompatible with budgets and maximising health gains. In New Zealand, pharmaceutical investments can only be considered ‘cost-effective’ when prioritised against other proposals at the time, and threshold levels must inevitably vary with available funds and the other criteria. Full article

(This article belongs to the Special Issue Health Economics)

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