Methods for public health economic evaluation: A Delphi survey of decision makers in English and Welsh local government

Emma Frew*, Katie Breheny

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)

Abstract

Standard reference case methods recommended for health technology appraisals do not translate well to a public health setting. This paper reports on a Delphi survey designed to elicit views of public health decision makers in England and Wales, about different methodological elements of economic evaluation. This is important as methods should align with the objective function of decision makers. The Delphi survey comprised two rounds, with round 1 allowing open-ended recommendations in addition to 5-point Likert scale responses. The final survey comprised 36 questions, and levels and strength of agreement were assessed using median values and mean absolute deviation of the median. The Delphi panel (n = 66) achieved high levels of agreement for costs, health, well-being, and productivity impact to be important elements within an economic evaluation. The panel agreed that evaluations should be relevant to the local context and include costs and consequences over a lifetime horizon. There was a call for the transparent reporting of costs and effects for different population subgroups, and for different sectors. Overall, the panel revealed a preference for a flexible approach, understanding that economic evidence fits within a dynamic process of decision making. These results provide empirical evidence to inform guidelines for public health economic evaluation.

Original languageEnglish
Pages (from-to)1052-1063
Number of pages12
JournalHealth Economics
Volume28
Issue number8
Early online date7 Jun 2019
DOIs
Publication statusPublished - 1 Aug 2019

Bibliographical note

© 2019 John Wiley & Sons, Ltd.

Keywords

  • economic evaluation
  • government policy
  • public health

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