Health Economics

Health economics is a rapidly expanding collaborative research program that cuts across Divisions and involves many of the projects undertaken at the Institute. A key objective of this program is to optimise the value from new and existing studies by incorporating, where appropriate, some form of economic analysis. The program has three main components: Research, Policy Engagement and Capacity Building.

Research

The program encompasses four broad ranging and novel approaches to economic analysis and involves collaborations with research partners both within and outside the Institute such as the School of Public Health, University of Sydney and the Menzies Centre for Health Policy.

Economic evaluation and utility based quality of life measurement

This is the most visible program stream and involves incorporating an economic evaluation into new and existing intervention studies. At present, the cost effectiveness analyses are underway or being planned for ADVANCE, GAP, Kanyini-GAP, INTERACT, MARKER, SHARP and China Rural Health Initiative (CRHI). Two significant sub-components of this stream are the valuation of quality of life in patients with chronic illnesses and economic modelling.

Health systems development and evaluation

This stream examines the delivery of health sector interventions, particularly in low and middle income settings, where efforts to implement and sustain evidence-based interventions take place against a background of often pressing shortages of resources and weak social and government institutions. An understanding of these issues can inform: 1) the design of health system interventions through this program (in Australia and overseas) that seek to be both evidence based (effective and cost-effective) and sustainable and; 2) the evaluation of these interventions for which outcomes are likely to be multi-dimensional. Appropriate forms of economic evaluation therefore engage complex measures and use mixed methods. CRHI, Kanyini and the Serious and Continuing Illness Policy and Practice Study (SCIPPS) involve research in this stream.

Household economic impact of illness

Chronic illness has potentially profound economic impacts on patients and their households particularly for those from socioeconomically disadvantaged groups and for patients with severe disability. This stream involves two approaches:

• Examining such impacts within a cohort of ill individuals. This enables an assessment of the degree of economic hardship associated with certain illnesses, its change over the course of illness and the factors that may influence the risk of such economic outcomes. Examples of where this is currently underway are SCIPPS, ChinaQUEST, POISE, and SEISMIC.
• Estimating the economic impact within evaluation studies to compare the effect of an intervention on this outcome. This entails the development of summary measures routinely incorporated into the follow-up of patients. This is particularly relevant to interventions that seek to reduce or prevent major disability, promote access to care and target socioeconomically disadvantaged groups. We explore the use of these measures within CRHI, SCIPPS, LEGS and MARKER.
• Through the deployment and refinement of these approaches, we seek to standardise the way in which these issues are addressed and in doing so ensure that concerns about equity are prominent in the research agenda for chronic illnesses.

Policy research

This aspect of the program involves research that address immediate policy-specific questions. One example is research into community and patient preferences. e.g. PARADOX which examines community preferences in relation to kidney donor programs.

Another project commissioned by the US Institute of Medicine to examines the costs of addressing current treatment gaps for in Cardiovascular Disease in developing countries.

Policy engagement

In addition this program allows us to increase our direct involvement in the policy process, particularly in the implementation of strategies arising from our research. Examples of this engagement include membership of the Economics Sub-committee of the Pharmaceutical Benefits Advisory Committee of the Commonwealth Department of Health and Aging and the Aboriginal and Population Health Priority Taskforce of NSW Health.

Capacity Building

HERMES is funded in 2009 by five year a NHMRC Capacity Building Grant (2009-13) and involves training, salary and scholarship support for a number of early career health economists.

PhD students

• Beverley Essue
• Tracey Laba
• Anne Marie Thow
• Ha Nguyen

Teaching

• Beverly Essue is an Associate Lecturer in the Masters of Health Policy program, University of Sydney
• Stephen Jan runs a module in Health Economics in the Masters of Health Policy, University of Sydney

The Health Economics Collaboration includes health economists across the University of Sydney, National Drug and Alcohol Research Centre, University of NSW and the George Institute. We run regular training workshops and seminars.

Guest lectures

Recent lectures include:Australian Faculty of Public Health Physicians John Hopkins University, Bloomberg School of Public Health