An introduction to health technology assessment and health economic evaluation: an online self-learning course

Abstract

Cardiovascular diseases impose an enormous burden on patients and society. New health technologies promise to lower this burden; however, novel treatments often come at a high cost. In the Netherlands, health technology assessment (HTA) is increasingly being used to inform policy bodies about the optimal distribution of scarce healthcare resources and to guide decision-making about financing and reimbursement. In particular, economic evaluations, as one pillar of HTA, are frequently used to compare the costs and effects of different interventions. This paper aims to define HTA and its relevance to healthcare policy as well as providing a comprehensive overview of the methodology of economic evaluations targeting health professionals and researchers with limited prior knowledge of this subject. Accordingly, different types of economic evaluations are introduced, together with their respective costs and outcomes. Further, the results of economic evaluations are explained, along with techniques for performing them and methods for coping with uncertainty. In addition to this paper-based learning format, each chapter is complemented by a video lecture with further information and practical examples, helping to better understand and analyse health economic studies.

Keywords: Cardiovascular disease; Economic evaluations; Health economics; Health technology assessment; Quality-adjusted life years; Resource use.

Fig. 1

Infographic

Fig. 2

Overview of cost types and perspectives

Fig. 3

Overview of economic evaluations with corresponding outcomes based on Drummond et al. [15]

Fig. 4

a, b Fictitious example of a cost-effectiveness plane including Monte Carlo simulations and a cost-effectiveness acceptability curve. The cost-effectiveness plane a includes 500 fictitious Monte Carlo simulations and a willingness to pay (WTP) line based on the Dutch threshold of 20,000 Euros per quality-adjusted life year gained (QALY); the cost-effectiveness acceptability curve b represents how many simulations fall below a certain threshold