Title: Health Economic Evaluation Methods
Keywords: Resource management (in general)
Monitoring and evaluation
Measuring health status
Health economics
Country: Sweden
Institution: Sweden - Department of Epidemiology and Global Health, Umeå University
Course coordinator: Klas-Gorán Sahlén
Date start: 2020-02-10
Date end: 2020-02-21
About duration and dates: 2 weeks. The course comprises 2 weeks. Starting a Monday in mid-February and ending a Friday two weeks later when a written exam is being held. There are no required activities (e.g. reading or assignments) before or after these dates.
Classification: advanced optional
Mode of delivery: Face to face
Course location: At Umeå University

Epidemiology and Global Health
Department of Public Health and Clinical Medicine
Umeå University
Sweden
tropEd representative: Marie Lindkvist
marie.lindkvist@umu.se
http://www.phmed.umu.se/english/units/epidemiology/
ECTS credit points: 3 ECTS credits
SIT: 80 SITs
Teaching: Interactive lectures, 38 SITs
Computer exercises (life tables and quality
adjusted survival analysis)8 SITs
Individually written exam: 5 SITs
Self-study hours: 29 SITs

In Sweden one week is equal to 1.5 ECTS credits and comprises a maximun of 40 SITs.
Language: English
Description:
At the end of the module the students should be able to:
- Discuss different features of the most common health economic evaluation methods in relation to the basic economic theory and the different concepts that underpin them.
- Analyze the advantages and drawbacks of different health economic evaluation methods.
- Select an evaluation method and Appraise why a selected evaluation is the most appropriate method for the evaluation of a given health intervention.
- Critically and comprehensively assess health economic evaluations that are reported in scientific journals
Assessment Procedures:
On Friday, during the second course week, a five hour closed-book written exam is given. The exam includes both shorter questions and essay questions. The purpose of the former is to test students’ knowledge of different features of the evaluation methods. The purpose of the essay questions is to is to test students’ ability to discuss the evaluation methods in relation to economic theory, to analyze advantages and drawbacks of the methods and to appraise which method that is most appropriate for a given health intervention. This motivates the relatively long duration of the written exam, which makes for 100% of the assessment.

The ECTS Grading Table is used at Umeå University. This means that the ECTS grading scale (A-F) is not used to translate grades for comparison to grades issued from other higher education institutions. The student will receive a transcript of records from the study documentation system (Ladok) showing the distribution of awarded grades since the course was established and until the date when the student has completed the course. However, this grade distribution will not be shown for courses established less than two years before the date when a student completes the course. For more information, go to https://www.umu.se/en/education/study-system/

The grades given are three; fail, pass and pass with distinction. A student who fails the course is allowed to take re-sit exams. The first re-sit exam is given three to four weeks after the course is finished and a second re-sit is given in the end of May/beginning of June.
Content:
This module consists of the following sections

Economic theory and concepts in relation to evaluation
Different types of economic evaluation
- Why is economic evaluation important?
- Different techniques
- What are the relevant costs and consequences?
Cost analysis
- The choice of perspective, societal or not?
- Which costs should be considered?
- Average, marginal and incremental costs
- The timing of costs, discounting
Cost-effectiveness analysis (CEA)
- When should CEA be used?
- How to obtain effectiveness data
- Should effects be discounted?
- Cost-effectiveness ratios
- The use of life tables
- Critical assessment of a published article
Cost-utility analysis (CUA)
- When should CUA be used?
- Measuring preferences
- Quality adjusted life years (QALYs)
- QALYs and Disability adjusted life years (DALYs) compared
- Critical assessment of a published article
Cost-benefit analysis (CBA)
- Valuing health effects in money
- Contingent valuation studies in health care
- Designing a willingness-to-pay study
Welfarism and extra-welfarism
Presentation of economic evaluation results
Methods:
The teaching on the course consists of lectures (34 SITs), group work 4 SITs, computer exercises 8 SITs, exam 5 SITs and self-study 29 SITs.
The lectures are interactive and students are encouraged to prepare for lectures by reading the relevant course literature beforehand. During some lectures students present and discuss their solutions to group assignments. The students work in groups of 4-5 students.
Independent self-study is also an important part of the learning – for preparation of lectures and group work and for integrating the new knowledge following lectures.
Prerequisites:
The requirements are 120 ECTS, of which a minimum of 30 ECTS are within one of the following: health sciences, environmental health or social sciences.
Proficiency in English equivalent to Swedish upper secondary course English A/5 (IELTS (Academic) with a minimum overall score of 5.5 and no individual score below 5.0. TOEFL PBT (Paper-based Test) with a minimum total score of 530 and a minimum TWE score of 4. TOEFL iBT (Internet-based Test) with a minimum total score of 72 and a minimum score of 17 on the Writing Section).
Attendance:
The maximum total number of students is 60. The tropEd students will be studying together with the students on our master programmes in public health. These programme students will take a 5 credits course in health economic evaluation methods. The first 3 credits on that course are the same as the 3 credits course described in this submission form.
Selection:
Applicants in the master programmes in public health at Umeå University have guaranteed admission to this course In addition to those, students (among them tropEd students) applying for the course as a single subject course may be accepted until the maximum number of students (60) is reached. The selection process for these latter students is based on the number of ECTS credits that each applicant has. Students are ranked according to his/hers number of ECTS credits so that the student with the highest number is first selected and so on until the maximum number of students is reached.
Fees:
There are no application and tuition fees for students who are citizens of countries within the European Economic Area (EU, Iceland, Liechtenstein and Norway)) or of Switzerland.

Students who are not citizens of a country covered by the EEA agreement or of Switzerland at the time they apply for studies must pay an application fee of 900 SEK (≈ 90 EUR at an exchange rate of approx.10 SEK per euro) to the university.
Those who are admitted and start studying at the university must pay tuition fees. For this course the present tuition fee is 7420 SEK (≈742 EUR at the above exchange rate). For more information about this, see https://www.universityadmissions.se/en/All-you-need-to-know1/Applying-for-studies/Fees-and-scholarships/
Scholarships:
There are no scholarships available at this time.
Major changes since initial accreditation: The course coordinator is new but he has been one of the central lecturers on the course for many years. The objectives are also the same. The content has changed in one respect. Computer exercises comprising survival analysis adjusted for changes in health related quality of life has been added. The reason for this is that the students have wished for a more hands on approach concerning these parts of the course.
Student evaluation: The students take this course together with students on the 5 credit course in health economic evaluation methods. The first 3 credits on the latter course are the same as the 3 credits course described in this submission form. (This has been pointed out under item 17 above.)
Only a few tropEd students have taken the course, less than a handful. There have been no special student evaluations for these. However, students on our master programmes taking the 5 credits course are very positive. In the course evaluation surveys students rate different course aspects on a scale from 1 (lowest) to 5 (highest). The quality of the course and teaching methods are rated between 3.5 and 4 and for questions such as “How do you value the course in terms of new and relevant knowledge for you” and “How would you assess the way you have been treated in general as a student during the course” the rating is close to 4.5.
In these evaluations it is not uncommon for students to wish for even more of interaction in lectures and more of group work. As teachers we have tried to find an optimal balance between lecturing, explaining and discussing.
Lessons learned: In the fall of 2017 a labor market day was arranged with a particular emphasis on health economics. Previous master students with one of our degrees (public health with a specialization in health economics) were invited as well as employer representatives from both the public and private sphere. One conclusion from the presentations and discussions during the day was that the is both a large and a growing demand for people with a competence in health economics. Another conclusion was that our courses in health economics are well suited to the job requirements that our graduates, now working as health economists, have met.

The course in health economic evaluation is the first of our courses in health economics. As such it provides a good base for those of our students that wants to specialize in health economics taking more of the courses in this field. It is also a good base for students who wish to specialize in other public health fields but need the knowledge of what economic evaluation in the health field means.
tropEd accreditation:
Accredited in Lisbon, May 2012; reaccredited in Berlin, Oct 2018. This accreditation is valid until Oct 2023.
Remarks:
There are two books used as course literature:
Drummond MF(ed). Methods for the Economic Evaluation of Health Care Programmes. Oxford: Oxford university press, latest edition
Gray AM, Clarke PM, Wolstenholme JL, Wordsworth S. Applied Methods of Cost-effectiveness Analysis in Health Care
Oxford University Press, latest edition
The first book is a standard reference text in the field of health economic evaluation. The second book includes computer exercises well suited for this course.
In addition to this a number of scientific articles is used being distributed to our students via our electronic course site.

Students must bring their own laptop
Email Address: klas-goran.sahlen@umu.se
Date Of Record Creation: 2012-07-16 02:57:20 (W3C-DTF)
Date Of Record Release: 2019-10-21 08:14:43 (W3C-DTF)
Date Record Checked: 2016-10-22 (W3C-DTF)
Date Last Modified: 2019-12-10 13:25:25 (W3C-DTF)

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