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Striving for a Societal Perspective: A Framework for Economic Evaluations When Costs and Effects Fall on Multiple Sectors and Decision Makers

Author

Listed:
  • Simon Walker

    (University of York)

  • Susan Griffin

    (University of York)

  • Miqdad Asaria

    (LSE Health, London School of Economics)

  • Aki Tsuchiya

    (University of Sheffield)

  • Mark Sculpher

    (University of York)

Abstract

In most societies, resources are distributed by individuals acting in markets and by governments through some form of collective decision-making process. Economic evaluation offers a set of tools to inform collective decisions by examining the resource requirements and outcomes of alternative policies. The ‘societal perspective’ has been advocated, but less consideration has been given to what this should include and its practical implementation. This paper presents a framework for economic evaluation of policies with costs and outcomes falling on different sectors (e.g. health, criminal justice, education) and involving different decision makers. It extends the ‘impact inventory’ developed by the Second Panel on Cost-Effectiveness in Health and Medicine by considering all affected individuals and reflecting how outcomes attributed to an intervention can be compared with outcomes forgone as a result of resources not being available for other purposes. The framework sets out the series of assessments to be made, distinguishing points at which value judgements feed into the evaluation, and the implications of alternative judgements. These assessments reflect the institutional arrangements of public bodies, for example, their funding, the outcomes they consider important and their relative valuations of these outcomes. By avoiding the use of an abstract ‘societal perspective’, the contribution of the framework is to inform multiple decision makers with different objectives and provide practical guidance on overall societal impact.

Suggested Citation

  • Simon Walker & Susan Griffin & Miqdad Asaria & Aki Tsuchiya & Mark Sculpher, 2019. "Striving for a Societal Perspective: A Framework for Economic Evaluations When Costs and Effects Fall on Multiple Sectors and Decision Makers," Applied Health Economics and Health Policy, Springer, vol. 17(5), pages 577-590, October.
    • Handle: RePEc:spr:aphecp:v:17:y:2019:i:5:d:10.1007_s40258-019-00481-8
    DOI: 10.1007/s40258-019-00481-8
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    References listed on IDEAS

    as
    1. Miqdad Asaria & Susan Griffin & Richard Cookson, 2013. "Distributional cost-effectiveness analysis: a tutorial," Working Papers 092cherp, Centre for Health Economics, University of York.
    2. Karl Claxton & Simon Walker & Steven Palmer & Mark Sculpher, 2010. "Appropriate Perspectives for Health Care Decisions," Working Papers 054cherp, Centre for Health Economics, University of York.
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    8. Laura Catherine Edney & Hossein Haji Ali Afzali & Terence Chai Cheng & Jonathan Karnon, 2018. "Estimating the Reference Incremental Cost-Effectiveness Ratio for the Australian Health System," PharmacoEconomics, Springer, vol. 36(2), pages 239-252, February.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Opportunity costs, marginal productivity, and cost-effectiveness thresholds: what are they and how are they related?
      by Rita Faria, Jessica Ochalek, jameslomas88 in The Academic Health Economists' Blog on 2020-09-23 06:00:00

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    Cited by:

    1. Basu, Anirban, 2020. "A welfare-theoretic model consistent with the practice of cost-effectiveness analysis and its implications," Journal of Health Economics, Elsevier, vol. 70(C).
    2. Marco Hafner & Erez Yerushalmi & Fredrik L. Andersson & Teodor Burtea, 2023. "Partially different? The importance of general equilibrium in health economic evaluations: An application to nocturia," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 654-674, March.
    3. Sean P. Gavan & Stuart J. Wright & Fiona Thistlethwaite & Katherine Payne, 2023. "Capturing the Impact of Constraints on the Cost-Effectiveness of Cell and Gene Therapies: A Systematic Review," PharmacoEconomics, Springer, vol. 41(6), pages 675-692, June.
    4. Matthew Franklin & James Lomas & Gerry Richardson, 2020. "Conducting Value for Money Analyses for Non-randomised Interventional Studies Including Service Evaluations: An Educational Review with Recommendations," PharmacoEconomics, Springer, vol. 38(7), pages 665-681, July.
    5. Sebastian Hinde & Simon Walker & Hugues Lortie-Forgues, 2019. "Applying the three core concepts of economic evaluation in health to education in the UK," Working Papers 170cherp, Centre for Health Economics, University of York.
    6. Edward Cox & Simon Walker & Charlotte L. Edwardson & Stuart J. H. Biddle & Alexandra M. Clarke-Cornwell & Stacy A. Clemes & Melanie J. Davies & David W. Dunstan & Helen Eborall & Malcolm H. Granat & L, 2022. "The Cost-Effectiveness of the SMART Work & Life Intervention for Reducing Sitting Time," IJERPH, MDPI, vol. 19(22), pages 1-14, November.
    7. Francesco Ramponi & Simon Walker & Susan Griffin & Steve Parrott & Colin Drummond & Paolo Deluca & Simon Coulton & Mona Kanaan & Gerry Richardson, 2021. "Cost‐effectiveness analysis of public health interventions with impacts on health and criminal justice: An applied cross‐sectoral analysis of an alcohol misuse intervention," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 972-988, May.
    8. Fatimah, Alfariany & Britteon, Philip & Turner, Alex J & Anselmi, Laura & Gillibrand, Stephanie & Wilson, Paul & Sutton, Matt & Lau, Yiu-Shing, 2023. "Evaluating whole system reforms: A structured approach for selecting multiple outcomes," Health Policy, Elsevier, vol. 138(C).
    9. William V. Padula & Hui-Han Chen & Charles E. Phelps, 2021. "Is the Choice of Cost-Effectiveness Threshold in Cost-Utility Analysis Endogenous to the Resulting Value of Technology? A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 19(2), pages 155-162, March.
    10. Mark Sculpher & Stephen Palmer, 2020. "After 20 Years of Using Economic Evaluation, Should NICE be Considered a Methods Innovator?," PharmacoEconomics, Springer, vol. 38(3), pages 247-257, March.
    11. Emma Frew & Nafsika Afentou & Hamideh Mohtashami Borzadaran & Paolo Candio & Irina Pokhilenko, 2022. "Using Economics to Impact Local Obesity Policy: Introducing the UK Centre for Economics of Obesity (CEO)," Applied Health Economics and Health Policy, Springer, vol. 20(5), pages 629-635, September.
    12. Sebastian Hinde & Helen Weatherly & Gabriella Walker & Lorna K. Fraser, 2021. "What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?," IJERPH, MDPI, vol. 18(21), pages 1-11, November.
    13. Tuba Saygın Avşar & Xiaozhe Yang & Paula Lorgelly, 2023. "How is the Societal Perspective Defined in Health Technology Assessment? Guidelines from Around the Globe," PharmacoEconomics, Springer, vol. 41(2), pages 123-138, February.
    14. Claudia Fischer & Susanne Mayer & Nataša Perić & Judit Simon, 2022. "Harmonization issues in unit costing of service use for multi-country, multi-sectoral health economic evaluations: a scoping review," Health Economics Review, Springer, vol. 12(1), pages 1-13, December.
    15. Manuel Gomes & Elizabeth Murray & James Raftery, 2022. "Economic Evaluation of Digital Health Interventions: Methodological Issues and Recommendations for Practice," PharmacoEconomics, Springer, vol. 40(4), pages 367-378, April.
    16. James Lomas & Jessica Ochalek & Rita Faria, 2022. "Avoiding Opportunity Cost Neglect in Cost-Effectiveness Analysis for Health Technology Assessment," Applied Health Economics and Health Policy, Springer, vol. 20(1), pages 13-18, January.
    17. Baudouin Standaert & Christophe Sauboin & Quentin J. Leclerc & Mark P. Connolly, 2021. "Comparing the Analysis and Results of a Modified Social Accounting Matrix Framework with Conventional Methods of Reporting Indirect Non-Medical Costs," PharmacoEconomics, Springer, vol. 39(2), pages 257-269, February.
    18. Sebastian Hinde & Laura Bojke & Peter Coventry, 2021. "The Cost Effectiveness of Ecotherapy as a Healthcare Intervention, Separating the Wood from the Trees," IJERPH, MDPI, vol. 18(21), pages 1-13, November.
    19. Ana Duarte & Simon Walker & Andrew Metry & Ruth Wong & Jasmina Panovska-Griffiths & Mark Sculpher, 2021. "Jointly Modelling Economics and Epidemiology to Support Public Policy Decisions for the COVID-19 Response: A Review of UK Studies," PharmacoEconomics, Springer, vol. 39(8), pages 879-887, August.
    20. Irina Pokhilenko & Luca M. M. Janssen & Mickael Hiligsmann & Silvia M. A. A. Evers & Ruben M. W. A. Drost & Aggie T. G. Paulus & Leonarda G. M. Bremmers, 2021. "The Relative Importance of Education and Criminal Justice Costs and Benefits in Economic Evaluations: A Best–Worst Scaling Experiment," PharmacoEconomics, Springer, vol. 39(1), pages 99-108, January.
    21. Candio, Paolo & Meads, David & Hill, Andrew J. & Bojke, Laura, 2021. "Taking a local government perspective for economic evaluation of a population-level programme to promote exercise," Health Policy, Elsevier, vol. 125(5), pages 651-657.
    22. Jonathan Karnon & Brita Pekarsky, 2020. "Should Health Economic Evaluations Undertaken from a Societal Perspective Include Net Government Spending Multiplier Effects?," Applied Health Economics and Health Policy, Springer, vol. 18(4), pages 467-475, August.

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