Ongoing Research Projects of the Division

Multi-Instrument Comparison (MIC) Study

Economic evaluation of medical interventions often relies on cost effectiveness analyses, which report incremental cost per quality-adjusted life year (QALY) gained. Then, decreasing cost per QALY is interpreted as an indicator of increasing social desirability.

In order to enable the calculation of QALYs and QALY gains, health-related quality of life (HRQoL) needs to be measured on a cardinal scale by a validated generic instrument. The MIC Study was designed as an international research project in Australia, North America (Canada and USA), United Kingdom, Norway, and Germany, to explore the relative performance of and differences between the major generic instruments used to transform measurements of HRQoL into utility scores. Michael Schlander acted as Principal Investigator for the German arm of the study. In order to pursue evaluations of the unique German dataset (comprising answers of 1,269 respondents), we are currently in the process of seeking funding that will enable the development of cross-walks between the generic multi-attribute utility (MAU) theory-based instruments, and mapping of disease-specific instruments on MAU instruments, all based on the preferences of German respondents.

European Social Preferences Measurement (ESPM) Project

The goal of this project is to examine whether or not, and if so, to what extent the conventional health economic evaluation model omits characteristics (or "attributes") of health and health care that are of importance to the public. A discrete choice experiment (DCE) methodology is applied to assess the relative weights of severity, age (or "fair innings"), prevalence (or "rarity"), clinical effectiveness (separated for impairments of quality of life and life expectancy) and costs; to compare the valuation results from DCE with those based on the logic of cost effectiveness; to assess the sensitivity of weights to the level of information provided (potential "framing effects"); and to assess the potential interaction between attributes. The project is designed to overcome some of the major limitations of prior studies, such as (in most cases) relatively small sample sizes, use of unrepresentative convenience samples, restricted scope (with regard to attributes tested), problems with incomplete information (especially with regard to the potential implications of prevalence), observed choice aversion and unstable preferences, as well as framing effects, and/or the often-imposed "zero sum" (or fixed budget) assumption.

Value of a Statistical Life Year (VSLY) Project

The economic evaluation of medical interventions almost always implies some sort of (informal or formal) cost benefit analysis. Essential dimensions of health-related benefits are length and quality of life. There is, however, far-reaching uncertainty as to the appropriate anchor value of a statistical life year (VSLY). In the absence of a valid VSLY, a central point of reference is missing for most of the commonly used types of cost benefit analysis. Against this background, a systematic review of the relevant economic literature has been done, enabling the analysis of the contribution of empirical economic studies to our understanding of the VSLY and its drivers.

The Economics of Colorectal Cancer

Colorectal cancer (CRC) is the third most common cancer in men and the second in women in developed countries, accounting for 0.74 million new cases and 0.33 million deaths in 2012. The economic burden of CRC in the European Union in 2009 alone was estimated to amount to €13.1 billion. Early detection and treatment through CRC screening with stool-based tests, sigmoidoscopy or colonoscopy has been shown to be strongly associated with CRC mortality reduction, and some evidence also indicates that these CRC screening strategies are cost effective when compared to no screening. There remain, however, open research questions; for example, as to how different strategies compare economically, and whether- or to what extent - efforts to increase participation rates in screening programs will be cost effective, too. Hence, research has been initiated to better understand the costs of CRC care in Germany, to systematically review and update recent evidence on the cost-effectiveness of CRC screening, and to use economic modeling to evaluate the cost-effectiveness of CRC screening strategies.

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