Journal of Preventive Medicine and Public Health

Special Article

The Primary Process and Key Concepts of Economic Evaluation in Healthcare: Younhee Kim, Yunjung Kim, Hyeon-Jeong Lee, Seulki Lee, Sun-Young Park, Sung-Hee Oh, Suhyun Jang, Taejin Lee, Jeonghoon Ahn, Sangjin Shin; J Prev Med Public Health. 2022;55(5):415-423. Published online August 24, 2022; DOI: https://doi.org/10.3961/jpmph.22.195

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Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

Summary

Korean summary
보건의료분야에서 경제성 평가는 의약품과 진단검사 및 치료법 등 의료기술에 대한 평가에서 널리 활용되고 있다. 본 연구에서는 경제성 평가절차를 경제성 평가 설계, 결과 산출, 비용산출, 모형 구축 및 분석, 비용-효과성 결과 제시 및 불확실성 평가와 의사 결정 단계로 나누어 주요 개념과 쟁점들을 소개하였다.

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Original Article

Estimation of Utility Weights for Prostate-related Health States in Korea: Seon-Ha Kim, Minsu Ock, Min-Woo Jo, Sungchan Park; J Prev Med Public Health. 2022;55(3):243-252. Published online May 4, 2022; DOI: https://doi.org/10.3961/jpmph.21.426

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Abstract Summary PDF Supplementary Material

Objectives
Very limited previous research has investigated the utility weights of prostate-related diseases in the general population in Korea. The purpose of this study was to calculate the utility of prostate-related health states in the Korean general public using the standard gamble (SG) method.
Methods
Seven health states for hypothetical prostate cancers, 1 for benign prostate hyperplasia, and 1 for erectile dysfunction were developed based on patient education material and previous publications. In total, 460 responses from the Korean general population were used to analyze the utility of prostate-related health states. Computer-assisted personal interviews were conducted, and utility values were measured using a visual analogue scale (VAS) and SG. Mean utility values were calculated for each prostate-related health state.
Results
The mean utility values of prostate cancer derived from SG ranged from 0.281 (metastatic castration-refractory prostate cancer) to 0.779 (localized prostate cancer requiring prostatectomy). The utility value of benign prostate hyperplasia was 0.871, and that of erectile dysfunction was 0.812. The utility values obtained using the SG method in all conditions were higher than the values obtained by VAS. There were no significant demographic variables affecting utility values in multivariate analysis.
Conclusions
Our findings might be useful for economic evaluation and utility calculation of screening and interventions for prostate-related conditions in the general population.

Summary

Korean summary
이 연구는 일반인구집단을 대상으로 7개의 전립선 암 상태와 전립선 비대증, 발기부전상태의 효용값을 표준기회선택법을 이용하여 산출하였다. 전립선암 상태에 따라 평균 효용값은 0.281에서 0.779범위였다. 연구 결과는 전립선 관련 상태의 중재의 효용 계산이나 경제성 평가에 활용할 수 있을 것이다.

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English Abstract

Socioeconomic Costs of Food-Borne Disease Using the Cost-of-Illness Model: Applying the QALY Method.: Hosung Shin, Suehyung Lee, Jong Soo Kim, Jinsuk Kim, Kyu Hong Han; J Prev Med Public Health. 2010;43(4):352-361.; DOI: https://doi.org/10.3961/jpmph.2010.43.4.352

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Abstract PDF

OBJECTIVES
This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. METHODS: Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. RESULTS: The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 - 76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. CONCLUSIONS: Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.

Summary

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