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Background

Economic evaluation of perinatal interventions traditionally focuses on the perspective of the child when collecting relevant cost and outcomes data, and when presenting cost-effectiveness results. A burgeoning recent literature defends that researchers should assess the importance of incorporating health benefits and other economic aspects of carers when conducting economic evaluations of health interventions. Institutions, such as the National Institute for Health and Care Excellence (NICE) in the UK and elsewhere, have been assessing the inclusion of these aspects in their guidance for methods of technology appraisals since 2010. In the perinatal and maternal health area, it would be uncommon to identify a scenario where a particular child’s condition does not have an important effect on the quality of life and economic well-being of other family members. Going beyond the child perspective into a family perspective introduces key challenges to traditional methods of cost-effectiveness analysis including: what measure of health benefit to use (QALYs, DALYs, capabilities approach), how to measure quality of life impact, how to aggregate health benefits among family members, how to incorporate family and other indirect costs into the analysis, and how to appropriately present cost-effectiveness and associated uncertainty into the results. This DPhil proposal will explore these issues and will provide guidance on a potential methodology to conduct economic evaluation of perinatal interventions from a family perspective in future studies.

Research Experience, Research Methods and Training

This studentship will provide experience and training in literature review methods, statistical methods to account for different levels of variability (child, siblings, parents and household), stated-preference elicitation techniques to understand parent’s preferences to a potential summary measure of benefits, and the use of decision analytical models as a potential tool to synthesise evidence of relevant costs and effects parameters for different family members to undertake a cost-effectiveness analysis. It is expected that the student will explore in detail different approaches to measure and aggregate health benefits and costs from a family perspective, will be responsible for data management of costs and outcome datasets with children’s and parents’ information, and will evaluate how the identified methodology links to the theoretical grounds of cost-effectiveness analysis.

Prospective Candidate

This project would suit a candidate with a strong quantitative (e.g. mathematics, statistics or economics) background and/or a proven track record of previous experience in applied economic evaluations and an interest in the development of methodology to conduct cost effectiveness analyses.

 

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