Dublin, September 2012

Koen Putman, Lieven Annemans, Katrien Beeckman, Maaike Fobelets

Health economic evaluation of the intervention (WP 5)

Concept

  In OptiBIRTH, health economic modelling will be used to estimate cost-effectiveness of the intervention.

  If VBAC is increased and this in turn reduces comorbidities after delivery, there will be possibly large economic benefits;

  The resulting net investment (initial investment minus future savings) will be balanced with the predicted health gain (expressed in avoided DALYs).

  1. To determine variation in costs between countries (base comparison)

  2. To determine cost-effectiveness of the intervention, as measured in the RCT (WP4)

Goals in WP5

What is aHealth Economic Evaluation?

The comparative analysis of alternative courses of action in terms of BOTH their costs and

health consequences

Related to OptiBIRTH:

“standard care” vs OptiBIRTH programme

OptiBIRTH: costs

  Societal perspective– Health care perspective– Out-of-pocket contributions

  Time horizon: 6m post partum

OptiBIRTH: costs

  Costs– Direct medical costs– Direct non-medical costs (e.g. transport)– Indirect costs (e.g. # days away from work)– Intervention group: all costs associated

with the programme

OptiBIRTH: data collection

  Direct medical costs– Inpatient hospital (claims) data– Diaries (women)

  Direct non-medical costs– Diaries (women)

  Indirect costs – Diaries, questionnaires (women)

OptiBIRTH: intervention

Important note:

Only the resource use/costs related to implementing/running the programme need to be accounted for.

OptiBIRTH: intervention

1. To identify the relevant costs items associated with the intervention• Time spent by (pre)implementation team• Time spent by midwives/obstetricians • Time spent by pregnant women• Materials for launching and performing the

program2. To measure the costs in natural units3. To assign a unit cost to each item

OptiBIRTH: Health consequences

– DALY averted– OptiBIRTH: temporary YLD (6M)– Joint measure for mother and child

  M1-M13: development of data collection sheets and translation into Italian and German

  M13: drafts sent to the national coordinators (PIs) (MHH, NUIG, UNIGE) and to AIMS for review and final approval

  M18 report on international comparison on variation of prenatal standard care between countries submitted

  M14-M20: data collection for pilot   M21-M36: data collection for trial   M36-M44: data analysis   M45: comparison with main trial outcomes   M45-48: report written

Time line

To do’s in next 12 months

  Base comparison between countries– Inventory on organisation and financing aspects in

perinatal care– Contact with country-PI’s for verification– Comparative matrix on “standard care”

  Preparation of materials for data collection– Materials in English– Translation– Data collection strategies

Health economic evaluation of the intervention (WP 5)

Dublin, September 2012

Koen Putmankputman@vub.ac.be