Health
Economics
from Theory to
Practice
Optimally informing related
decisions of reimbursement,
research and regulation in practice.
22 – 24 November 2017
1 Macquarie Place Circular Quay
Course
Details
Key References
Covered
SUITABLE FOR
Briggs A., O’Brien B. The Death of Cost Minimization Analysis, Health
Economics, 2001;10:179–184.
Health policy researchers, health policy makers, evaluators of health technology assessment, Health economists,
research active health care professionals.
Briggs A., O’Brien B., and Blackhouse G. Thinking outside the box:
recent advances in the analysis and presentation of Uncertainty in cost
effectiveness studies. Annual Review of Public Health, 2002; 23: 377–
401.
WHAT IS THE COURSE?
The course teaches best practice for optimally addressing joint reimbursement, research and regulation
(efficiency monitoring, funding pricing) decisions and policies associated with cost effectiveness analysis, health
technology assessment and health system practice.
OBJECTIVES
Using seminars and tutorial-based learning with methods provided in Excel spreadsheets, the course provides
participants with the principles, practical skills, methods and software to:
1. Robustly and appropriately evaluate cost effectiveness of alternative health care interventions (Briggs,
O’Brien and Blackhouse 2002; Willan and Briggs 2006) or health promotion and prevention strategies (Sheill
at al. 2008; Hawe et al. 2009; Eckermann et. al .2014) and related policies (Eckermann 2014) consistent with
budget constrained maximizing of societal net benefit (Pekarsky 2012; Eckermann and Pekarsky 2014).
2. Undertake unbiased analysis of cost effectiveness evidence and avoid common inferential fallacies in health
economic analysis in processes of evidence synthesis (Briggs and O’Brien 2001; Eckermann, Coory and Willan
2009) and evidence translation (O’Brien 1996; Eckermann, Coory and Willan 2011)
3. Undertake research design using value of information methods to maximise expected value relative to cost
of research allowing for appropriate decision context, including time, opportunity costs and option value of
delay, and imperfect implementation (Eckermann and Willan 2007, 2008, 2009, 2013; Eckermann, Karnon
and Willan 2010; Kent, Briggs, Eckermann and Berry 2013; Willan and Eckermann 2010, 2012)
4. Best compare cost effectiveness of multiple strategies with use of expected net-loss curves and frontiers,
which directkly and simply inform societal decision making of optimal strategies for reimbursement at any
threshold value with current evidence and the potential future value of future research (Eckermann Briggs
and Willan 2008; Eckermann and Willan 2011).
5. Best compare cost effectiveness of multiple outcomes under uncertainty (McCaffrey 2012; McCaffrey et al
2013, 2014), critical for comparisons of areas such as palliative care, but also transparency, generalizability
and robust decision interpretation of events and utility weights underlying quality adjusted life year analysis.
6. Undertake efficiency measurement and funding across health-care providers consistent with maximizing
health system net benefit (Eckermann 2004; Eckermann and Coelli 2013). The NBCT method naturally
extends multiple strategy methods in HTA (see 4 above) to enable budget constrained net benefit maximizing
quality of care incentive in practice, while preventing cost-shifting and cream skimming incentives.
Eckermann S. Health Economics from Theory to Practice: Optimally
Informing Joint Decisions of Research, Reimbursement and Regulation
with Health System Budget Constraints and Community Objectives.
Cham, Switzerland. Springer. 2017. DOI 10.1007/978-3-319-50613-5.
Eckermann S, Sheridan L. Supporting Medicare Health, Equity and
Efficiency in Australia: Policies Undermining Bulk Billing Need to Be
Scrapped. Applied Health Economics and Health Policy. 2016 ;14(5):
511-5.
Eckermann S, Willan AR. Appropriately estimating EVSI with imperfect
implementation: improving practice and reducing uncertainty with
appropriate counterfactual consideration. Medical Decision Making.
2016: 36(3); 282-283.
Eckermann S, Sheridan L, Ivers R. Which direction should Australian
health system reform be heading? ANZJPH. 2016; 40(1):7-9.
Eckermann S. Over and underservicing: further reasons to scrap the GP
co-payment. The Conversation, August 7 2014. http://
theconversation.com/over-and-under-servicing-further-reasonstoscrapthe-gp-co-payment-30199.
Eckermann S. Avoiding a health system hernia and the associated
outcomes and costs. ANZJ Public Health. 2014; 38(4): 303–305.
Eckermann S., Dawber J., Yateman H., Quinsey K., Morris D. Evaluating
return on investment in a school-based health promotion and
prevention program: the investment multiplier for the Stephanie
Alexander Kitchen Garden National Program. Social Science and
Medicine. 2014; 114: 103-112.
Eckermann S., Pekarsky B. Can the real opportunity cost stand up:
displaced services the straw man outside the room.
PharmacoEconomics. 2014; 32(4): 319–325. http:// www.
springerlink.com/openurl.asp?genre=article&id=d oi:10.1007/
s40273-014-0140-3.
Eckermann, S., Coelli, T. 2013. ‘Including quality attributes in efficiency
measures consistent with net benefit: creating incentives for evidence
based medicine in practice’. Social Science & Medicine. 76: 159–168.
Eckermann, S., Willan, A. 2013. ‘Optimal global VOI trials: better
aligning manufacturer and decision maker interest and enabling feasible
risk sharing’. PharmacoEconomics. 31: 393–401.
Eckermann S., Coory M., Willan A.R. 2009. ‘Indirect comparison:
relative risk fallacies and odds solution’ Journal of Clinical
Epidemiology. 62: 1031–1036.
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. 2008, ‘Time and Expected Value of Sample
Information Wait for No Patient’. Value in Health. 11: 522–526.
Eckermann, S., Willan, A.R. 2008, ‘The Option Value of Delay in Health
Technology Assessment’. Medical Decision Making. 28: 300– 305.
Eckermann, S., Willan, A.R. 2007, ‘Expected Value of Information and
Decision Making in HTA’. Health Economics. 16: 195–209. Kent S.,
Briggs A.,
Eckermann S., Berry C. Are value of information methods ready for
prime time? International Journal for Technolgy Assessment in Health
Care. 2013; 29 (4): 435–442.
McCaffrey N., Skuza P., Breaden K., Eckermann S., Hardy J., Oaten S.,
Briffa M., Currow D. Preliminary development and validation of a new
end-of-life patient-reported outcome measure assessing the ability of
patients to finalise their affairs at the end of life. PLoS ONE 2014; 9(4):
e94316. doi:10.1371/journal.pone.0094316.
McCaffrey N., Agar M., Harlum J., Karnon J., Currow D., Eckermann S.
Is home-based palliative care cost effective? An economic evaluation of
the Palliative Care Extended Packages at Home (PEACH) pilot. BMJ
Supportive & Palliative Care. 2013. doi:10.1136/ bmjspcare-2012-000361.
McCaffrey, N., M. Agar, J. Harlum, J. Karnon, D. Currow and S.
Eckermann (2015). Better informing decision making with multiple
outcomes cost-effectiveness analysis under uncertainty in costdisutility
space. PLoS One 10(3), e0115544.
McCaffrey, N., H. Al-Janabi, D. Currow, R. Hoefman and J. Ratcliffe
(2016). Protocol for a systematic review of preference-based instruments
for measuring care-related outcomes and their suitability for the
palliative care setting. BMJ Open accepted for publication 20th July.
McCaffrey, N., S. Bradley
McCaffrey, N., J. B. Cassel and J. Coast (2015). Bringing the economic
cost of informal caregiving into focus. Palliat Med 29(10), 866-867
O’Brien B. 1996. Economic evaluation of pharmaceuticals.
Frankenstein’s monster or vampire of trials? Med Care. 1996 Dec; 34 (12
Suppl): DS99-108.
Eckermann, S., Willan, A. 2011. ‘Presenting evidence and summary
measures to best inform societal decisions when comparing multiple
strategies’. PharmacoEconomics. 29(7): 563–577.
Ratcliffe J and Currow D (2016). What Aspects of Quality of Life Are
Important From Palliative Care Patients’ Perspectives? A Systematic
Review of Qualitative Research. Journal of Pain and Symptom
Management 52(2), 318- 328.e315.
Eckermann, S., Coory M, Willan A. 2011. ‘Consistently estimating
absolute risk difference when translating evidence to jurisdictions of
interest’. PharmacoEconomics. 21(10): 1183–1195. doi:10.1002/
hec.1781.
Willan, A., Eckermann, S. 2012. ‘Expected value of information and
pricing new health care interventions. PharmacoEconomics. 30(6): 447–
459.
Eckermann, S., Karnon, J., Willan, A. 2010. ‘The value of Value of
Information: best informing research design and prioritization using
current methods’. PharmacoEconomics. 28(9): 699–709.
Willan, A.R., Eckermann, S. 2010. ‘Optimal clinical trial design using
value of information with imperfect implementation’. Health
Economics. 19: 549–561.
Eckermann, S., Willan, A.R. 2009. ‘Globally optimal trial design for local
decision making’. Health Economics. 18: 203–216.
Course
Structure
Day 1:
Reimbursement: principles and methods for
optimising decision making under uncertainty
Day 2: Research and reimbursement under uncertainty:
Optimal trial design within and across jurisdictions
0845–0900 Arrival with tea and coffee
0900 – 1000 Probabilistic Sensitivity Analysis (PSA) —from parameter uncertainty to net benefit uncertainty
0900–1030 Principles and practice of economic evaluation in health technology assessment: coverage,
comparability, opportunity costs and thinking outside the box
1000–1100 Joint Research and reimbursement decisions: Value of information (VoI) to decision makers &
principles for efficient trial design
1030–1045 Morning Tea Break
1100–1115 Morning Tea Break
1045–1215 Frankenstein’s Monster or Vampire of Trials: avoiding inferential fallacies in evidence synthesis
and translation
1115–1215 Optimal global trial design and decision making
1215–1300 Lunch
1215–1245 VOI and pricing with optimal global trial design: Better aligning manufacturer and decision
maker interest and enabling feasible risk sharing.
1300–1400 Decision Analysis, and Decision Tree Methods
1245–1330 Lunch
1415–1445 Extrapolating cost-effectiveness evidence for a jurisdiction of interest
1330–1430 1445–1515 Afternoon Tea Break
Best informing societal decisions when comparing two or more strategies: the cost-disutility
plane and expected net loss curves and frontiers
1515–1615 Principles and practical methods for economic evaluation of community based health
promotion and prevention programs
1430–1500 Tutorial: ENL curves and frontiers
1500–1530 Afternoon Tea Break
1615–1700 Beyond QALYs – the importance of multiple outcome domains, particularly in palliative care
1530–1700 Multiple outcome comparisons—robust presentation and summary measures
Day 3: Research, reimbursement and regulation in practice
900–11.00 The net benefit correspondence theorem: creating incentives for evidence based medicine in
practice
1100–1115 Morning Tea Break
1115–1215 Tutorial: Comparing provider efficiency in practice consistent with maximising benefit
1215–1300 Lunch
1300–1400 Bridging the Silos: maximising quality within a budget
1400–1500 Opportunity cost of reimbursement: the economically meaningful threshold value
1500–1530 Afternoon Tea Break
1530–1700 Health care policy with an ageing population: where should health and aged care reforms be
heading?
Speakers
Sydney Business School, University of Wollongong
DR NIKKI MCCAFFREY
His original research and collaborations have established missing links between optimal decision making in research,
reimbursement and regulation in practice and are extensively published in the highest impact health economics and
decision making Journals, and clinical and policy journals with his applied research.
Faculty of Medicine, Nursing and Health Sciences,
Flinders University
Nikki McCaffrey is a health economist with a pharmacy background and
over ten years’ experience in health technology assessment and health
economic analysis in palliative care. She works for Flinders Health
Economics Group and the Palliative Care Clinical Studies Collaborative
(PaCCSC), a national collaboration of researchers engaged in Phase III
studies in palliative care.
Dr McCaffrey has been successful as: a researcher, applying qualitative
and quantitative approaches in palliative care economic evaluation,
outcome measurement, the quality use of medicines, healthy ageing and
epidemiology; a health technology evaluator, critiquing applications
to the Australian Pharmaceutical Benefits Advisory Committee; and a
pharmaceutical adviser, providing guidance to over 40 GPs regarding the
cost-effective use of medicines.
Dr McCaffrey is an investigator on competitive research grants totalling more than A$4 million. Her original
research includes:
• Comparison in cost-disutility space to best inform risk neutral or risk averse decision makers when comparing
more than two strategies with multiple outcomes in health technology assessment;
• Outcome measurement in palliative care economic evaluations, including the development of disease specific
preference based economic measures;
• Evaluation of community models of palliative care; and
• Development of discrete choice attributes from qualitative data.
Dr McCaffrey is an advisory group member for the Specialist Palliative Care and Advance Planning Advisory
Service for Aged Care, a national project funded by the government ($14.95 mill), a research executive member
of the South Australian Palliative Care Clinical Network, and a PaCCSC Scientific Committee board member.
Formal academic qualifications include an honours degree in pharmacy, postgraduate diplomas in clinical
pharmacy and health economics and policy, a master’s degree in prescribing sciences and pharmacoeconomics,
and a doctoral degree in health economics.
PROFESSOR SIMON ECKERMANN
Simon Eckermann is Senior Professor of Health Economics at the Australian Health Services Research
Institute and University of Wollongong.
Related principles and methods have been taught by Professor Eckermann to more than 500 students from a wide
range of clinical, research, policy and health technology assessment backgrounds since 2000, with the 'Health
Economics from Theory to Practice' course he established with Professor Willan in 2005 consistently rated by
participants as the best course of its type internationally.
The related Health Economics from Theory to Practice text (Eckermann 2017) combines principles and robust
methods for jointly optimising:
(i) Evidence synthesis and translation (Eckermann, Coory and Willan 2009, 2011);
(ii) Comparison of multiple strategies (Eckermann, Briggs and Willan 2008; Eckermann and Willan 2011);
(iii) Evaluation of health promotion and prevention programs allowing for network multiplier effects (Eckermann et
al 2014);
(iv) Health care efficiency and providers in practice consistent with maximising net benefit in allowing for quality of
care (Eckermann and Coelli 2013; Eckermann 2004);
(v) Multiple domain comparisons, particularly critical to evaluation of areas such as palliative care (McCaffrey et al
2015);
(vi) Research design allowing for relevant policy contexts (Eckermann, Karnon and Willan 2010; Eckermann and
Willan 2008, 2009, 2011, 2013; Willan and Eckermann 2010, 2012);
(vii) Adoption, pricing and financing of new technology consistent with the health shadow price (Pekarsky 2012,
2014, Eckermann and Pekarsky 2014) and;
(viii) Health and aged care policy reform for budget constrained successful ageing of baby boomer populations policy
(Eckermann 2014; Eckermann and Sheridan 2016; Eckermann, Sheridan and Ivers 2016).
He is a CI on competitive research grants totalling more than A$25 million since 2005 and actively sits on and
undertakes guideline revision and health economics educational activities for National decision bodies including the
Pharmaceutical Benefits Advisory Committee Economic Sub-Committee (PBAC ESC 2005-2010), National Palliative
Care Trials Scientific Committee (2006-2014), Prostheses List Advisory Committee (2012-2014), Victorian Cancer
Agency (2015-) and Food Standards ANZ (2017-) as well as various NHMRC grant review committees.
REGISTRATION
The three-day workshop fees include all seminar and tutorial teaching materials, plus lunch each day.
Academic / Public Sector: A$1700
Private / Commercial Sector: A$2500
If you wish to register for the three-day Health Economics: From Theory to Practice: Optimally
Informing Related Decisions of Reimbursement, Research and Regulation in Practice, visit:
www.sydneybusinessschool.edu.au/about/events/health-economics
To purchase the book; Health Economics from Theory to Practice - Optimally Informing Joint Decisions of
Researc, Riembeursement and Regualtion with Helath System Budget Contraints and Community Objectives,
visit:
www.springer.com/gp/book/9783319506111
Registration Closing Date: 10 November 2017
Cancellation Policy
A refund will be returned less AUD$100 administration fee for a cancellation up to 10 November 2017.
THERE WILL BE NO REFUNDS after 10 November 2017.
Workshop size strictly limited to 25 delegates.
For further information please contact:
Megan Edgar
School of Management Operations and Marketing
Faculty of Business
University of Wollongong NSW2522
T: +61 2 4221 4264
E: [email protected]