Please find the assignment question in attachment.

Globally, the economic evaluation of healthcare programs has become one of the most essential in the last few years. Off late, it is now considered as a gold standard tool for the appraisal of healthcare programs. Economic evaluation can be defined as ‘the comparative analysis of alternative courses of action in terms of both their costs and consequences”. (Attema, A. E., Brouwer, W., & Claxton, K, 2018)
It mainly focuses on two main sections-
· Costs and consequences of programs
· Choices and decision making in the allocation of resources.
Health economics aims to answer two main questions:
· Effectiveness of the proposed health procedure compared with other methods
· Satisfaction and options of the people regarding the health care budget allocation.
Increase in health care costs and availability of limited resources costs makes the economic evaluation as a pivotal factor in our day to day practice. Health economics is very much needed in the healthcare system as it ensures that people living across the globe receive the required effective health care services without financial hardships. It is also useful in identifying the best course of action required for the health procedure.
Benefits in the can be measured in two ways based upon the health status:
· Direct benefits (e.g.- direct medical costs and direct nonmedical costs like social services, family expenditure)
· Indirect benefits (e.g.- production gains)
A full economic evaluation comprises four types (Robinson R, 1993)
· Cost-Benefit Analysis (CBA)
· Cost Effective Analysis (CEA)
· Cost-Utility Analysis (CUA)
· Cost Minimization Analysis (CMA)
COST-BENEFIT ANALYSIS:
• Cost-benefit analysis whether something is worth doing and addresses the concept of efficiency.
• It puts a monetary value on both costs and benefits.
• It allows schemes in different areas of health and outside health to be compared.
Advantages:
Helps to identify the economic alternatives
Limitations:
It is difficult to express all possible health and social benefits in monetary terms (intangible benefits).
COST-UTILITY ANALYSIS (CUA):
• It is mainly concentrates on overcoming the concerns of expressing all the benefits in terms of money.
• It measures the health consequences are measured in units that estimate the quality of the health outcome associated with a particular intervention.
• Different people value different health states in different ways.
• It measures 2 effects (quality and length of life).
Advantages:
• Patient outcomes comprising of quality and length of life can be incorporated in the analysis.
Limitations:
• The measurement may vary from person to person (respondents).
• Benefits within CUA are often measured in terms of Quality-adjusted life years (QALYs).
• QALYs are based on both survival and quality of life measures.
• It is calculated by, multiplying the duration of health state by the QALY weight for the health state.
COST BENEFIT ANALYSIS (CBA)-
• Cost-benefit analysis whether something is worth doing and addresses the concept of efficiency.
• It puts a monetary value on both costs and benefits.
• It allows schemes in different areas of health and outside health to be compared.
Advantages:
Helps identify the economic alternatives
Limitations:
It is difficult to express all possible health and social benefits in monetary terms (intangible benefits).
OTHER FORMS OF EVALUATIONS:
1. COST CONSEQUENCE ANALYSIS:
• In some cases, often where studies consider multiple outcomes, costs and benefits are presented in a disaggregated form.
• It is always appropriate to present the results in disaggregated form. This will help in ensuring that all the outcomes can be carefully considered within a framework of evaluation.
2. COST OF ILLNESS (COI) STUDIES (not true economic evaluations):
Attempt to represent the burden of disease from a particular ailment or medical condition in monetary terms.
3. PROGRAMME BUDGETING (PB) AND MARGINAL ANALYSIS (MA) (PBMA):
PB is the notion that it is important to understand how resources are cu
ently being spent before thinking about ways of modifying this pattern of resource use.
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