IDEAS home Printed from https://ideas.repec.org/p/ehl/lserod/101271.html
   My bibliography  Save this paper

Distributional cost-effectiveness analysis: a tutorial

Author

Listed:
  • Asaria, Miqdad
  • Griffin, Susan
  • Cookson, Richard

Abstract

Distributional cost-effectiveness analysis (DCEA) is a framework for incorporating health inequality concerns into the economic evaluation of health sector interventions. In this tutorial, we describe the technical details of how to conduct DCEA, using an illustrative example comparing alternative ways of implementing the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). The 2 key stages in DCEA are 1) modeling social distributions of health associated with different interventions, and 2) evaluating social distributions of health with respect to the dual objectives of improving total population health and reducing unfair health inequality. As well as describing the technical methods used, we also identify the data requirements and the social value judgments that have to be made. Finally, we demonstrate the use of sensitivity analyses to explore the impacts of alternative modeling assumptions and social value judgments.

Suggested Citation

  • Asaria, Miqdad & Griffin, Susan & Cookson, Richard, 2016. "Distributional cost-effectiveness analysis: a tutorial," LSE Research Online Documents on Economics 101271, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:101271
    as

    Download full text from publisher

    File URL: http://eprints.lse.ac.uk/101271/
    File Function: Open access version.
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Thomas F. Crossley & Cormac O'Dea & Facundo Alvaredo & Anthony B. Atkinson & Salvatore Morelli, 2016. "The Challenge of Measuring UK Wealth Inequality in the 2000s," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 13-33, March.
    2. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    3. Miqdad Asaria & Susan Griffin & Richard Cookson & Sophie Whyte & Paul Tappenden, 2013. "Distributional Cost-Effectiveness Analysis of Health Care Programmes," Working Papers 091cherp, Centre for Health Economics, University of York.
    4. Matthew Robson & Miqdad Asaria & Richard Cookson & Aki Tsuchiya & Shehzad Ali, 2017. "Eliciting the Level of Health Inequality Aversion in England," Health Economics, John Wiley & Sons, Ltd., vol. 26(10), pages 1328-1334, October.
    5. repec:bla:econom:v:50:y:1983:i:197:p:3-17 is not listed on IDEAS
    6. Karl Claxton & Steve Martin & Marta Soares & Nigel Rice & Eldon Spackman & Sebastian Hinde & Nancy Devlin & Peter C Smith & Mark Sculpher, 2013. "Methods for the estimation of the NICE cost effectiveness threshold," Working Papers 081cherp, Centre for Health Economics, University of York.
    7. Atkinson, Anthony B., 1970. "On the measurement of inequality," Journal of Economic Theory, Elsevier, vol. 2(3), pages 244-263, September.
    8. Paul Kind & Geoffrey Hardman & Susan Macran, 1999. "UK population norms for EQ-5D," Working Papers 172chedp, Centre for Health Economics, University of York.
    Full references (including those not matched with items on IDEAS)

    Citations

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


    Cited by:

    1. Matthew Robson & Miqdad Asaria & Richard Cookson & Aki Tsuchiya & Shehzad Ali, 2017. "Eliciting the Level of Health Inequality Aversion in England," Health Economics, John Wiley & Sons, Ltd., vol. 26(10), pages 1328-1334, October.
    2. Asaria, Miqdad & Mazumdar, Sumit & Chowdhury, Samir & Mazumdar, Papiya & Mukhopadhyay, Abhiroop & Gupta, Indrani, 2019. "Socioeconomic inequality in life expectancy in India," LSE Research Online Documents on Economics 100783, London School of Economics and Political Science, LSE Library.
    3. Dolly Han & Nicolas Iragorri & Fiona Clement & Diane Lorenzetti & Eldon Spackman, 2018. "Cost Effectiveness of Treatments for Chronic Constipation: A Systematic Review," PharmacoEconomics, Springer, vol. 36(4), pages 435-449, April.
    4. 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.
    5. Deidda, Manuela & Geue, Claudia & Kreif, Noemi & Dundas, Ruth & McIntosh, Emma, 2019. "A framework for conducting economic evaluations alongside natural experiments," Social Science & Medicine, Elsevier, vol. 220(C), pages 353-361.
    6. Miqdad Asaria, 2017. "Health care costs in the English NHS: reference tables for average annual NHS spend by age, sex and deprivation group," Working Papers 147cherp, Centre for Health Economics, University of York.
    7. James Love-Koh & Susan Griffin & Edward Kataika & Paul Revill & Sibusiso Sibandze & Simon Walker, 2019. "Incorporating concerns for equity into health resource allocation. A guide for practitioners," Working Papers 160cherp, Centre for Health Economics, University of York.
    8. Jessica Ochalek & Karl Claxton & Paul Revill & Mark Sculpher & Alexandra Rollinger, 2016. "Supporting the development of an essential health package: principles and initial assessment for Malawi," Working Papers 136cherp, Centre for Health Economics, University of York.
    9. Helen Weatherly & Rita Faria & Bernard Van den Berg & Mark Sculpher & Peter O’Neill & Kay Nolan & Julie Glanville & Jaana Isojarvi & Erin Baragula & Mary Edwards, 2017. "Scoping review on social care economic evaluation methods," Working Papers 150cherp, Centre for Health Economics, University of York.
    10. Paolo Candio & Koen B. Pouwels & David Meads & Andrew J. Hill & Laura Bojke & Claire Williams, 2022. "Modelling decay in effectiveness for evaluation of behaviour change interventions: a tutorial for public health economists," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1151-1157, September.
    11. Rachael Taylor & Deborah Sullivan & Penny Reeves & Nicola Kerr & Amy Sawyer & Emma Schwartzkoff & Andrew Bailey & Christopher Williams & Alexis Hure, 2023. "A Scoping Review of Economic Evaluations to Inform the Reorientation of Preventive Health Services in Australia," IJERPH, MDPI, vol. 20(12), pages 1-47, June.
    12. 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.
    13. Kirwin, Erin & Meacock, Rachel & Round, Jeff & Sutton, Matt, 2022. "The diagonal approach: A theoretic framework for the economic evaluation of vertical and horizontal interventions in healthcare," Social Science & Medicine, Elsevier, vol. 301(C).
    14. Luyten, Jeroen & Kessels, Roselinde & Atkins, Katherine E. & Jit, Mark & van Hoek, Albert Jan, 2019. "Quantifying the public's view on social value judgments in vaccine decision-making: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 228(C), pages 181-193.
    15. Dukhanin, Vadim & Searle, Alexandra & Zwerling, Alice & Dowdy, David W. & Taylor, Holly A. & Merritt, Maria W., 2018. "Integrating social justice concerns into economic evaluation for healthcare and public health: A systematic review," Social Science & Medicine, Elsevier, vol. 198(C), pages 27-35.
    16. McNamara, Simon & Tsuchiya, Aki & Holmes, John, 2021. "Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment," Social Science & Medicine, Elsevier, vol. 269(C).
    17. Hill, Sarah R. & Vale, Luke & Hunter, David & Henderson, Emily & Oluboyede, Yemi, 2017. "Economic evaluations of alcohol prevention interventions: Is the evidence sufficient? A review of methodological challenges," Health Policy, Elsevier, vol. 121(12), pages 1249-1262.
    18. Simon McNamara & John Holmes & Abigail K. Stevely & Aki Tsuchiya, 2020. "How averse are the UK general public to inequalities in health between socioeconomic groups? A systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 275-285, March.
    19. Carlos Campillo-Artero & Jaume Puig-Junoy & Anthony J. Culyer, 2018. "Does MCDA Trump CEA?," Applied Health Economics and Health Policy, Springer, vol. 16(2), pages 147-151, April.

    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. Miqdad Asaria & Susan Griffin & Richard Cookson, 2016. "Distributional Cost-Effectiveness Analysis," Medical Decision Making, , vol. 36(1), pages 8-19, January.
    2. Richard Cookson & Shehzad Ali & Aki Tsuchiya & Miqdad Asaria, 2018. "E‐learning and health inequality aversion: A questionnaire experiment," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1754-1771, November.
    3. Miqdad Asaria & Susan Griffin & Richard Cookson & Sophie Whyte & Paul Tappenden, 2013. "Distributional Cost-Effectiveness Analysis of Health Care Programmes," Working Papers 091cherp, Centre for Health Economics, University of York.
    4. Guido Erreygers & Roselinde Kessels, 2017. "Socioeconomic Status and Health: A New Approach to the Measurement of Bivariate Inequality," IJERPH, MDPI, vol. 14(7), pages 1-23, June.
    5. Joan Costa-Font & Frank Cowell & Joan Costa-i-Font, 2024. "Specific Egalitarianism? Inequality Aversion across Domains," CESifo Working Paper Series 11261, CESifo.
    6. Antonio Abatemarco & Massimo Aria & Sergio Beraldo & Michela Collaro, 2023. "Measuring Access and Inequality of Access to Health Care: a Policy-Oriented Decomposition," CSEF Working Papers 666, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
    7. McNamara, Simon & Tsuchiya, Aki & Holmes, John, 2021. "Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment," Social Science & Medicine, Elsevier, vol. 269(C).
    8. Donna Rowen & John Brazier & Clara Mukuria & Anju Keetharuth & Arne Risa Hole & Aki Tsuchiya & Sophie Whyte & Phil Shackley, 2016. "Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life," Medical Decision Making, , vol. 36(2), pages 210-222, February.
    9. Hurley, Jeremiah & Mentzakis, Emmanouil & Walli-Attaei, Marjan, 2020. "Inequality aversion in income, health, and income-related health," Journal of Health Economics, Elsevier, vol. 70(C).
    10. Paolo Li Donni & Vito Peragine & Giuseppe Pignataro, 2014. "Ex‐Ante And Ex‐Post Measurement Of Equality Of Opportunity In Health: A Normative Decomposition," Health Economics, John Wiley & Sons, Ltd., vol. 23(2), pages 182-198, February.
    11. Antonio Abatemarco & Sergio Beraldo & Francesca Stroffolini, 2020. "Equality of opportunity in health care: access and equal access revisited," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 67(1), pages 13-29, March.
    12. AMENDOLA, Alessandra & BOCCIA, Marinella & MELE, Gianluca & SENSINI, Luca, 2019. "Fiscal Policies and Firms' Performance:A Propensity Score Matching Analysis inDominican Republic," CELPE Discussion Papers 159, CELPE - CEnter for Labor and Political Economics, University of Salerno, Italy.
    13. Micaela Pinho & Anabela Botelho, 2018. "Inference Procedures to Quantify the Efficiency–Equality Trade-Off in Health from Stated Preferences: A Case Study in Portugal," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 503-513, August.
    14. Shaun Da Costa & Owen O'Donnell & Raf Van Gestel, 2023. "Distributionally Sensitive Measurement and Valuation of Population Health," Tinbergen Institute Discussion Papers 23-017/V, Tinbergen Institute.
    15. Christian Pietro & Marco M. Sorge, 2018. "Stochastic dominance and thick-tailed wealth distributions," Journal of Economics, Springer, vol. 123(2), pages 141-159, March.
    16. Barbosa, Estela Capelas & Cookson, Richard, 2019. "Multiple inequity in health care: An example from Brazil," Social Science & Medicine, Elsevier, vol. 228(C), pages 1-8.
    17. Miqdad Asaria, 2017. "Health care costs in the English NHS: reference tables for average annual NHS spend by age, sex and deprivation group," Working Papers 147cherp, Centre for Health Economics, University of York.
    18. Ngalesoni, Frida N. & Ruhago, George M. & Mori, Amani T. & Robberstad, Bjarne & Norheim, Ole F., 2016. "Equity impact analysis of medical approaches to cardiovascular diseases prevention in Tanzania," Social Science & Medicine, Elsevier, vol. 170(C), pages 208-217.
    19. Miqdad Asaria & Susan Griffin & Richard Cookson & Sophie Whyte & Paul Tappenden, 2015. "Distributional Cost‐Effectiveness Analysis of Health Care Programmes – A Methodological Case Study of the UK Bowel Cancer Screening Programme," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 742-754, June.
    20. Love-Koh, James & Pennington, Becky & Owen, Lesley & Taylor, Matthew & Griffin, Susan, 2020. "How health inequalities accumulate and combine to affect treatment value: A distributional cost-effectiveness analysis of smoking cessation interventions," Social Science & Medicine, Elsevier, vol. 265(C).

    More about this item

    Keywords

    cost-effectiveness analysis; economic evaluation; efficiency; equality; equity; fairness; health distribution; health inequality; inequality measures; opportunity cost; social value judgments; social welfare functions; tradeoff;
    All these keywords.

    JEL classification:

    • J50 - Labor and Demographic Economics - - Labor-Management Relations, Trade Unions, and Collective Bargaining - - - General

    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:ehl:lserod:101271. 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: LSERO Manager (email available below). General contact details of provider: https://edirc.repec.org/data/lsepsuk.html .

    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.