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An exercise on the feasibility of carrying out secondary economic analyses

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  • Tom Jefferson
  • Miranda Mugford
  • Alastair Gray
  • Vittorio Demicheli

Abstract

Purchasers of health services need up to date information on cost‐effectiveness of interventions to help in prioritising spending. But economists have not yet developed a formal methodology for reviewing and summing up evidence from individual economic evaluations which may have been conducted at different times and in different places, or indeed for assessing whether such systematic reviews are possible in this context. This paper discusses the problems of reviewing available economic information, using a body of literature on the economics of influenza vaccination to illustrate some relevant issues. First, the paper examines alternative methods for adjusting prices to take into account differences in currency and time periods: Retail Price Indices are compared with health specific inflation indices, and exchange rates are compared with Purchasing Power Parity (PPP) data. For the studies reviewed, the choice of conversion method made little practical difference. Secondly, the paper explores the possibility of summarising the results of a review in terms of quantities of resources used, rather than prices. This method is constrained by the available data, but could be more generally useful as it allows direct comparison of underlying technologies, and calculation of costs by attaching local unit costs to the resources associated with an intervention. These two exercises highlight many of the problems that arise in generalising from economic studies. Both methods need to be developed further if they are to be useful to decision makers.

Suggested Citation

  • Tom Jefferson & Miranda Mugford & Alastair Gray & Vittorio Demicheli, 1996. "An exercise on the feasibility of carrying out secondary economic analyses," Health Economics, John Wiley & Sons, Ltd., vol. 5(2), pages 155-165, March.
  • Handle: RePEc:wly:hlthec:v:5:y:1996:i:2:p:155-165
    DOI: 10.1002/(SICI)1099-1050(199603)5:23.0.CO;2-O
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    References listed on IDEAS

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    1. Parkin, David & McGuire, Alistair & Yule, Brian, 1987. "Aggregate health care expenditures and national income : Is health care a luxury good?," Journal of Health Economics, Elsevier, vol. 6(2), pages 109-127, June.
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    3. Gerdtham, Ulf-G. & Jonsson, Bengt, 1991. "Conversion factor instability in international comparisons of health care expenditure," Journal of Health Economics, Elsevier, vol. 10(2), pages 227-234, July.
    4. Tom Jefferson & Vittorio Demicheli, 1994. "Is vaccination against hepatitis b efficient? A review of world literature," Health Economics, John Wiley & Sons, Ltd., vol. 3(1), pages 25-37, January.
    5. Drummond, Michael & Torrance, George & Mason, James, 1993. "Cost-effectiveness league tables: More harm than good?," Social Science & Medicine, Elsevier, vol. 37(1), pages 33-40, July.
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