Research Initiative in Clinical Economics
Clinical economics studies describe and quantify the relative value of health care services. This research combines information on health outcomes of an intervention—usually its impact on the quality as well as length of life—with information on its cost, for use by decisionmakers in clinical, health system, and public policy settings.
The Research Initiative in Clinical Economics is integral to the Agency for Healthcare Research and Quality (AHRQ) goals of supporting research to improve the outcomes and quality of care and providing information that helps people make better decisions about health care.
AHRQ's Research Initiative in Clinical Economics identifies the following four priorities:
- Facilitate the use and enhance the credibility of economic analysis in decisionmaking through research, tool development, and training.
- Promote the availability of standardized inputs to cost-effectiveness and related studies.
- Support advances in methods for economic analysis.
- Provide targeted support for extramural clinical economics studies to inform health care decisionmaking.
These priorities build on a long-term interest in the field of cost-effectiveness and related work and are addressed through the full range of AHRQ's support mechanisms, including intramural studies, grants for investigator-initiated research, conference support, and cooperative arrangements with other agencies.
AHRQ has initiated several projects to support the development of improved systems and mechanisms for using CEA to inform decisionmaking:
- Evaluation of economic analysis in formulary decisionmaking to facilitate and guide improvements in this process. For details, go to: Evaluation of the American Managed Care Pharmacy Format for Formulary Submissions.
- Development of an innovative approach for allowing public citizens to provide informed input into resource allocation decisions. For details, go to: Deliberative Focus Groups: Citizen Input to Health Policy.
- Sponsorship of a Medical Care supplement on decision processes using CEA and the potential and obstacles to wider use of CEA (Medical Care 43:7 suppl, July 2005).
Future projects building on these efforts will include development of a strategic plan for integrating cost-effectiveness considerations in health policy decisions.
AHRQ Clinical Economics Research Database. Contains 544 health economic publications funded in part or entirely by Federal agencies and published from 1997 through 2001. Articles include cost-effectiveness and cost-utility analyses, as well as publications on related topics such as outcome measures that are directly linked to health economics research.
Harvard Center for Risk Analysis Cost-Effectiveness Analysis Registry. Contains 534 cost-utility analyses published from 1976 through 2001; the Registry will be expanded to include cost-effectiveness studies using cost per life-year as the cost-effectiveness ratio. Several publications are available that analyze the health economics literature based on the information in this database. AHRQ is the primary funder of this project. Go to: http://healtheconomics.tuftsmedicalcenter.org/cear4/Home.aspx
Preference weights for community-based measures of health-related quality of life derived from U.S. populations. An AHRQ-funded project on U.S. Valuation of the EuroQol EQ-5D™ Health States has established population-based preference values for the EQ-5D™'s 243 health states for use in the United States and compared EQ-5D™ health state values of the general population with those measured among U.S. Hispanic and non-Hispanic black populations. For publications describing results, survey data, and scoring algorithms, go to: U.S. Valuation of the EuroQol EQ-5D™ Health States.
Measures of health benefit for use in cost-effectiveness analysis of regulatory activities affecting health and safety. To improve consistency of health benefit measures used in cost-effectiveness analysis of regulatory interventions affecting health and safety, AHRQ is working with the Institute of Medicine (IOM) on a project to assess the scientific validity, ethical implications, and practical utility of a range of health benefit measures used or proposed in cost-effectiveness analysis.
For background on regulatory policy and guidance for agencies, and the increased emphasis on cost-effectiveness analysis in regulatory impact analysis, go to: Office of Management and Budget (OMB) 2003 Report to Congress.
Outcomes data from the Medical Expenditure Panel Survey (MEPS). AHRQ's nationally representative survey of health care utilization and expenditures in the U.S. non-institutionalized population offers EQ-5D™ health utility data suitable for use in economic analysis as well as SF-12 health status data. For additional information on the survey, data, and publications, go to: Medical Expenditure Panel Survey (MEPS).
AHRQ supports methods research in cost-effectiveness and related research, generally through grants and conferences.