IDEAS home Printed from https://ideas.repec.org/a/spr/aphecp/v18y2020i4d10.1007_s40258-020-00556-x.html
   My bibliography  Save this article

Should Health Economic Evaluations Undertaken from a Societal Perspective Include Net Government Spending Multiplier Effects?

Author

Listed:
  • Jonathan Karnon

    (Flinders Health and Medical Research Institute)

  • Brita Pekarsky

    (South Australian Ambulance Service)

Abstract

The fiscal multiplier represents the ratio of the change in national income to an associated increase in government spending. Fiscal multiplier effects are commonly estimated to justify options for government spending. Multiplier effects are not considered in economic evaluations of healthcare, but alternate forms of healthcare spending are expected to have varying multiplier effects. This paper describes the estimation and application of net government spending multiplier effects to two published economic evaluations. Negative net multiplier effects are estimated for an evaluated pharmaceutical for the treatment of stable cardiovascular disease, with a resulting increase in the published incremental cost per quality-adjusted life-year (QALY) gained from AU$31,244 to 47,311. Positive net multiplier effects are estimated for an evaluated healthcare delivery model for frail older people, with a resulting decrease in the published incremental cost per QALY gained from AU$8129 to 7669. The inclusion of net multiplier effects in economic evaluations undertaken from a societal perspective can have important effects on the estimated value of evaluated health technologies and services. The potential for government spending on healthcare to crowd out existing spending is considered low, but further investigation of crowding-out effects is warranted.

Suggested Citation

  • 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.
    • Handle: RePEc:spr:aphecp:v:18:y:2020:i:4:d:10.1007_s40258-020-00556-x
    DOI: 10.1007/s40258-020-00556-x
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40258-020-00556-x
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40258-020-00556-x?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. 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.
    2. Productivity Commission, 2008. "Modelling Economy-wide Effects of Future Automotive Assistance," Research Reports, Productivity Commission, Government of Australia, number 30, July.
    3. Commission, Productivity, 2011. "Disability Care and Support," Inquiry Reports, Productivity Commission, Government of Australia, volume 0, number 54, July.
    4. Nicoletta Batini & Luc Eyraud & Lorenzo Forni & Anke Weber, 2014. "Fiscal Multipliers; Size, Determinants, and Use in Macroeconomic Projections," IMF Technical Notes and Manuals 14/04, International Monetary Fund.
    5. Nicoletta Batini & Mr. Luc Eyraud & Lorenzo Forni & Miss Anke Weber, 2014. "Fiscal Multipliers: Size, Determinants, and Use in Macroeconomic Projections," IMF Technical Notes and Manuals 2014/004, International Monetary Fund.
    6. Jonathan Karnon & Hossein Haji Ali Afzali & Gregorius Virgianto Arpuji Anggoro Putro & Phyu Win Thant & Ameline Dompok & Ingrid Cox & Owen Henry Chikhwaza & Xian Wang & Mercy Mukui Mwangangi & Matahar, 2017. "A Cost-Effectiveness Model for Frail Older Persons: Development and Application to a Physiotherapy-Based Intervention," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 635-645, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 27th July 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-07-27 11:00:01

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Wei Jiang & Yadong Wang, 2023. "Asymmetric Effects of Human Health Capital on Economic Growth in China: An Empirical Investigation Based on the NARDL Model," Sustainability, MDPI, vol. 15(6), pages 1-16, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Paras Sachdeva & Wasim Ahmad & N. R. Bhanumurthy, 2023. "Uncovering time variation in public expenditure multipliers: new evidence," Indian Economic Review, Springer, vol. 58(2), pages 445-483, September.
    2. António Afonso & Eduardo Rodrigues, 2024. "Is public investment in construction and in R&D, growth enhancing? A PVAR approach," Applied Economics, Taylor & Francis Journals, vol. 56(24), pages 2875-2899, May.
    3. Thibault Lemaire, 2020. "Fiscal Consolidations and Informality in Latin America and the Caribbean," Post-Print halshs-02492309, HAL.
    4. Stanova, Nadja, 2015. "Effects of fiscal shocks in new EU members estimated from a SVARX model with debt feedback," MPRA Paper 63148, University Library of Munich, Germany.
    5. Afonso, António & Jalles, João Tovar, 2019. "The Fiscal consequences of deflation: Evidence from the Golden Age of Globalization," The Quarterly Review of Economics and Finance, Elsevier, vol. 74(C), pages 129-147.
    6. Clemens Fuest & Björn Kauder & Luisa Lorenz & Martin Mosler & Niklas Potrafke & Florian Dorn, 2016. "Hidden tax increases - the extra tax burden of the bracket creep and the expected impact of income tax rates "on wheels" on tax reliefs," ifo Forschungsberichte, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, number 76.
    7. Emilio Colombo & Davide Furceri & Pietro Pizzuto & Patrizio Tirelli, 2022. "Fiscal Multipliers and Informality," IMF Working Papers 2022/082, International Monetary Fund.
    8. Varthalitis, Petros, 2019. "FIR-GEM: A SOE-DSGE Model for fiscal policy analysis in Ireland," Papers WP620, Economic and Social Research Institute (ESRI).
    9. Colombo, Emilio & Furceri, Davide & Pizzuto, Pietro & Tirelli, Patrizio, 2024. "Public expenditure multipliers and informality," European Economic Review, Elsevier, vol. 164(C).
    10. Beau Soederhuizen & Rutger Teulings & Rob Luginbuhl, 2019. "Estimating the Impact of the Financial Cycle on Fiscal Policy," CPB Discussion Paper 398, CPB Netherlands Bureau for Economic Policy Analysis.
    11. György Molnár & Gábor Dániel Soós & Balázs Világi, 2017. "Fiscal Policy and the Business Cycle," Financial and Economic Review, Magyar Nemzeti Bank (Central Bank of Hungary), vol. 16(4), pages 58-85.
    12. Engelbert Stockhammer & Andre Novas Otero, 2023. "A tale of housing cycles and fiscal policy, not competitiveness. Growth drivers in Southern Europe," New Political Economy, Taylor & Francis Journals, vol. 28(3), pages 483-505, May.
    13. Aaron G. Grech & Brian Micallef & Sandra Zerafa & Tiziana M. Gauci (ed.), 2018. "The Central Bank of Malta’s First Fifty Years: A Solid Foundation for the Future," CBM Ebooks, Central Bank of Malta, edition 1, number 01.
    14. Bibhuti Ranjan Mishra, 2019. "The Size of Fiscal Multipliers in India: A State Level Analysis Using Panel Vector Autoregression Model," Global Business Review, International Management Institute, vol. 20(6), pages 1393-1406, December.
    15. Varun Chotia, 2019. "The Impact Of Fiscal Consolidation And Economic Growth On Debt: Evidence From India," Economic Annals, Faculty of Economics and Business, University of Belgrade, vol. 64(222), pages 63-80, July – Se.
    16. Angela Köppl & Margit Schratzenstaller, 2022. "Macroeconomic Effects of Green Recovery Programmes. Conceptual Framing and a Review of the Empirical Literature," WIFO Working Papers 646, WIFO.
    17. El Mostafa Bentour, 2023. "On the government consumption multipliers evolvement over time: an SVAR analysis," Applied Economics Letters, Taylor & Francis Journals, vol. 30(12), pages 1612-1617, July.
    18. Bettarelli, Luca & Furceri, Davide & Pizzuto, Pietro & Yarveisi, Khatereh, 2024. "Regional fiscal spillovers: The role of trade linkages," Journal of International Money and Finance, Elsevier, vol. 140(C).
    19. Teglio, Andrea & Mazzocchetti, Andrea & Ponta, Linda & Raberto, Marco & Cincotti, Silvano, 2019. "Budgetary rigour with stimulus in lean times: Policy advices from an agent-based model," Journal of Economic Behavior & Organization, Elsevier, vol. 157(C), pages 59-83.
    20. Ann Pettifor, 2019. "‘Deficit Financing’ or ‘Deficit-Reduction Financing?’ Debates in Contemporary Economics: Origins, Confusions and Clarity "تمويل العجز" أو "تخفيض العجز في التمويل؟" مناقشات في الاقت," Journal of King Abdulaziz University: Islamic Economics, King Abdulaziz University, Islamic Economics Institute., vol. 32(1), pages 67-78, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:aphecp:v:18:y:2020:i:4:d:10.1007_s40258-020-00556-x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.