Valuing the Economic Benefits of Complex Interventions
2013
This is a review of economic evaluations of complex health interventions. Complex interventions, involving interlinked packages of care, challenge the application of current methods of economic evaluation that focus on measuring only health gain. The authors find that complex interventions may be problematic on two levels.
First, the complexity means the intervention may not fit into one of the current appraisal systems, and/or second, maximizing health is not the only objective. This paper discusses the implications of a program of work that focused on clinical genetics services, as an example of a complex intervention, and aimed to identify the following: a) the attributes that comprise both health and non-health aspects of benefits, and b) whether it is possible to evaluate such an intervention using current National Institute for Health and Clinical Excellence (NICE) appraisal processes.
Genetic services and tests are a good example of a complex intervention and have broader objectives than just health gain, which may usefully be measured using the concept related to capability, which the authors have called ‘empowerment’. Further methodological work is required to identify the trade-off between non-health (empowerment) and health benefits for other complex interventions. The authors do not advocate a move away from QALY maximization but do suggest that there is a need for a more considered approach that can take account of the perceived value for non-health attributes for some complex interventions.
Valuing the Economic Benefits of Complex Interventions
Source:
Payne K, McAllister M, Davies LM. Valuing the Economic Benefits of Complex Interventions: When Maximising Health is not Sufficient. Health Economics 2013; 22: 258-271. https://doi.org/10.1002/hec.2795
Not open access.