Conducting Economic Evaluations Alongside Substance Use Disorder Clinical Trials: Statistical Methods and Best Practices | AHSR 2020

On Monday, January 11, 2021, CHERISH Research Affiliate and Pilot Grantee Ali Jalali, PhD, alongside Methodology Core Director Kathryn E. McCollister, PhD and Consultation Service Director Sean M. Murphy, PhD, conducted a workshop entitled “Conducting Economic Evaluations Alongside Substance Use Disorder Clinical Trials: Statistical Methods and Best Practices” at the 2020 virtual Addiction Health Services Research (AHSR) Conference.

This CHERISH (Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV) sponsored seminar provides an in-depth review of methods for conducting an economic evaluation alongside a clinical trial. Statistical methods frequently employed in applied health econometric studies (two-part, and generalized linear models, recycled predictions, mixed effects, longitudinal analysis, etc.), and best practices for data collection and analysis are discussed, with examples using Stata statistical software. This seminar is designed for investigators who have some familiarity with economic evaluations, but would benefit from a more detailed outline of the methods involved and examples of their application.

Slides are available here.

Training Module 1. Cost-Effectiveness Analysis (17min)

This training was modified from a presentation for Helping to End Addiction Long-term (HEAL) Health Economics training presented at Boston University on September 6, 2019. This training module introduces participants to economic evaluation methods, with an emphasis on cost-effectiveness analysis of treatment interventions of substance use disorder. In this training we describe the purpose and significance of an economic evaluation, and describe important considerations when conducting a cost-effectiveness analysis. At the end of this module, participants should be able to understand the components of a cost-effectiveness analysis and understand how the choice of perspective affects what is included in the economic evaluation.

Training Module 2. Cost Analysis (19min)

This training was modified from a presentation for Helping to End Addiction Long-term (HEAL) Health Economics training presented at Boston University on September 6, 2019. This training module introduces participants to costing techniques and considerations as the first component of an economic evaluation. We review the different types of costing methods and categories of cost, and describe important considerations when collecting costs for an economic evaluation. At the end of this module, participants should be able to describe the difference between macro-costing methods and micro-costing methods, and should be able to understand the different types of costs collected during a cost analysis. This module builds on module 1 as it describes the role of analytic perspective in determining which costs to include and the appropriate valuation of those resources.

Training Module 3. Health Utilities and Direct Utility Assessments (10 min)

This training module introduces participants to health-related quality of life assessments as a common measure of effectiveness in economic evaluations. We review different types of direct utility assessment techniques to measure health utilities and describe the important considerations of each technique. At the end of this module, participants should be able to define a health utility, and describe three direct utility assessment methods.

Training Module 4. Health Utilities and QALYs for Cost-Effectiveness Analyses (7 min)

This training module continues to describe health-related quality of life assessments as a common measure of effectiveness in economic evaluations. In this module we introduce algorithm-based quality of life measurement tools commonly used in economic evaluations. We describe the important considerations when selecting a quality of life assessment. We then explain how these quality of life measures are used to calculate Quality-Adjusted of Life Years (QALYs), which are a common measure of effectiveness for economic evaluations. At the end of this module, participants should be able to describe the differences between preference based, non-preference based, generic, and disease specific quality of life measurement tools, and understand how these utility measures are used to calculate quality-adjusted life years as a measure of effectiveness for economic evaluations.

Training Module 5. Cost-Benefit Analysis (14 min)

This training module introduces participants to cost-benefit analyses as another type of full economic evaluation. In this training module we explain the purpose and significance of a cost-benefit analysis, and describe important considerations when conducting cost-benefit analysis. At the end of this module, participants should be able to describe the methodological differences between a cost-benefit analysis and cost-effectiveness analysis, and understand when the use of a cost-benefit analysis is most appropriate.

Training Module 6. Budget Impact Analysis (7 min)

This training module introduces participants to the techniques used in conducting a budget impact analyses. In this training we explain the purpose and significance of a budget impact analysis, and describe important considerations when conducting a budget impact analysis. At the end of this module, participants should be able to understand when to conduct a budget impact analysis, how this information is used by stakeholders, and how the intended stakeholders affects the assessment methods selected.

An Introduction to Economic Evaluation in Substance Use Disorders | CALDAR (Pt 1-4: 2hr 40min)

Drs. Bruce Schackman and Sean Murphy of CHERISH lead a course entitled “An Introduction to Economic Evaluation in Substance Use Disorders” at the 2017 UCLA Summer Institute on Longitudinal Research in Universal City, California. The course was one of two workshops held on Wednesday, August 15 from 8:00AM to 11:45AM. The course provided an introduction to economic evaluation methods used to evaluate health care interventions, with a focus on cost-effectiveness analysis (CEA) of interventions for substance use disorders.