Health Economics

Associate Professor Simon Eckermann

Simon Eckermann is Associate Professor in Health Economics at the Flinders Centre for Clinical Change & Health Care Research, Flinders University. He has extensive experience in teaching and applying decision analytic methods for economic analysis in HTA, and currently sits on the Economic Sub-Committee of the PBAC. His original research includes methods for (i) using value of information for optimal research design and decision making in HTA accounting for decision context (adopt, delay) time, costs of reversal and opportunity costs of delay, and (ii) a correspondence method allowing ratio measures of relative efficiency consistent with maximizing net benefit.   email Simon   Read Simon's Curriculum Vitae

Health economics from theory to practice: informing related decisions of research, reimbursement and regulation

A Three-Day Workshop

Led by

Professor Andrew Willan
http://www.andywillan.com/willan/index.htm

- and -

A/Professor Simon Eckermann

1 - 3 December 2008

in the beautiful Barossa Valley, South Australia

or

26 - 28 August 2009 on the Isle of Raasay, Scotland

The discipline of health economics has expanded in recent years as decision makers globally have increasingly demanded robust processes and evidence to inform decisions such as:

I.   Whether to reimburse a new technology?
II.  Whether further research should be undertaken to inform reimbursement decisions?
III. How can evidence and reimbursement decisions best be translated into practice?
 
In addressing the first two sets of questions, health economics has provided increasingly sophisticated processes for:

1. Health technology assessment allowing for the joint uncertainty of cost and effects and how they translate to decision uncertainty (Willan and Briggs 2006). 
2. Efficient research design employing value of information (VOI) methods to maximise the expected value less expected costs of research (Claxton 1999).
 
However, while the first two sets of questions are clearly inter-related, their relationship and impact on optimal decision making had, until recent research by the course presenters, not been established.  Appropriately allowing for decision context (adopt, delay), costs of reversal, opportunity costs of delay and time has a significant impact on optimal research design and frameworks for decision making, as demonstrated by Eckermann and Willan (Eckermann and Willan 2007, Eckermann and Willan 2008c, Eckermann and Willan 2008b, Eckermann and Willan 2008a).

The relationship between optimal decision making for reimbursement and the potential value of research in HTA has also been explicitly demonstrated in comparing two or more strategies with the net loss acceptability frontier (Eckermann, Briggs and Willan 2008). In general these methods clarify, simplify and provide a more appropriate framework for optimal decision making in health technology assessment.   
 
The third question of economic methods to best translate evidence and decisions to practice and its relationship to the question of whether to reimburse and whether to research have also remained largely unanswered by health economics as a discipline. However, recent research by the course presenters demonstrate methods for measuring performance and value of information across multiple strategies and outcome domains consistent with maximising net benefit (Eckermann, Briggs and Willan 2008), which naturally extend to measuring efficiency in practice; (Eckermann 2004, Eckermann 2006, Eckermann 2007).
 
The course uses a seminar and tutorial based format to present from first principles and practically explore methods for optimal decision making, demonstrating the importance of allowing for each of questions I-III and their interaction. This extends existing courses for economic methods in HTA.
 

Claxton, K. 1999, 'The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies '. Journal of Health Economics 18, 341-364.

Eckermann, S. (2004) Hospital Performance Including Quality: Creating Economic Incentives Consistent with Evidence-Based Medicine. PhD Dissertation. Sydney, University of New South Wales, available at http://www.library.unsw.edu.au/~thesis/adt-NUN/public/adt-NUN20051018.135506/, accessed 29 May 2007.

Eckermann, S. 2006, 'Measuring performance consistent with evidence-based medicine in practice'. Centre for Applied Economic Research 2006 Working Paper Series No 6. http://www2.fce.unsw.edu.au/nps/servlet/portalservice?GI_ID=System.LoggedOutInheritableArea&maxWnd=_Publications_WorkingPaperSeries, ISBN 0 7334 2327 2.

Eckermann, S. 2007, 'Measuring hospital efficiency consistent with maximising net benefit'. Flinders Centre for Clinical Change & Health Care Research Working Paper Series ISBN 13-978-1-921402-00-5, available at http://clinicalchange.flinders.edu.au/Complete%20Working%20Paper%201%20Simon%20Eckermann.pdf.

Eckermann, S., Briggs, A. & Willan, A. R. 2008, 'Health Technology Assessment in the Cost-Disutility Plane'. Medical Decision Making, 28, 172-181.

Eckermann, S. & Willan, A. R. 2007, 'Expected value of information and decision making in HTA'. Health Economics, 16, 195-209.

Eckermann, S. & Willan, A. R. 2008a, 'Globally optimal trial design for local decision making'. Health Economics, Online early DOI 10.1002/hec.1353.

Eckermann, S. & Willan, A. R. 2008b, 'The Option Value of Delay in Health Technology Assessment'. Medical Decision Making, 28, 300-305.

Eckermann, S. & Willan, A. R. 2008c, 'Time and Expected Value of Sample Information Wait for No Patient'. Value in Health, 11, 522-526.

Willan, A. R. & Briggs, A. H. 2006 The Statistical Analysis of Cost-Effectiveness Data,  John Wiley & Sons, Chichester UK.

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Working Papers 2007

Last Revised 4 July, 2008