Research Initiative in Clinical Economics
Begun in 2001, the Research Initiative in Clinical Economics defines and focuses AHRQ's agenda of research and activities relating to cost-effectiveness analysis (CEA), cost-benefit analysis, and related methods for estimating the value of health care interventions.
Program Focus
Priorities
Policy Projects
Database Resources
Outcomes Measurement
Methods Research
Grants & Conferences
Related AHRQ Programs
Other Resources
Staff Contacts
Program Focus
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.
The Center for Outcomes and Evidence (COE) highlights an emphasis in clinical economics to conduct, support and facilitate the production of knowledge that informs the efficient allocation of health care resources.
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Priorities
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.
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Policy Projects
AHRQ has initiated several projects to support the development of improved systems and mechanisms for using CEA to inform decisionmaking:
Future projects building on these efforts will include development of a strategic plan for integrating cost-effectiveness considerations in health policy decisions.
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Database Resources
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. Go to: http://cerd.ahrq.gov
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://www.hsph.harvard.edu/cearegistry
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Outcomes Measurement
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 more information on Evaluating Measures of Health Benefits for Environmental, Health, and Safety Regulation, go to: http://www.iom.edu/project.asp?id=19739.
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).
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Methods Research
AHRQ supports methods research in cost-effectiveness and related research, generally through grants and conferences. Go to: Grants and Conferences.
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Grants and Conferences
AHRQ's grants in clinical economics include:
- Studies of the cost-effectiveness of specific interventions.
- Cost-effectiveness reviews.
- Methods studies, including development of statistical methods and quality of life measures.
Grants funded from 1999 to present are listed in AHRQ's Grants On-Line Database. Go to: http://www.gold.ahrq.gov
For a table of clinical economics grants, go to Clinical Economics Grants and Conferences.
Training: AHRQ supports 27 graduate programs in health services research through the National Research Service Award grants to institutions for predoctoral and postdoctoral training. Several of these programs emphasize training in health economics and/or cost-effectiveness analysis. For information on training grants, go to: http://www.ahrq.gov/fund/training/trainix.htm
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Related AHRQ Programs
For additional information in Focus on Cost-Effectiveness Analysis at the Agency for Healthcare Research and Quality, go to: http://www.ahrq.gov/research/costeff.htm.
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Other Public Resources of Interest
NHS Economic Evaluation Database. Funded by the National Health Service of England and Wales, this system identifies and describes economic evaluations, their quality, and relative strengths and weaknesses. Included are critical assessments by health economists with clinical effectiveness information, key components of the economic evaluations, overall reliability and generalizability of the studies, and practical implications. Go to: http://www.crd.york.ac.uk/crdweb/
Utility Measures. For an online text on utility measures, go to: http://symptomresearch.nih.gov/chapter_24/index.htm.
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Staff Contacts
Joanna E. Siegel, Sc.D.
Director, Research Initiative in Clinical Economics
Center for Outcomes and Effectiveness
Phone: (301) 427-1491
E-mail: Joanne.Siegel@ahrq.hhs.gov
Sepheen C. Byron, M.H.S.
Yen-Ping Chiang, Ph.D.
William F. Lawrence, M.D., M.S.
Other AHRQ Staff With Projects/Interests in Clinical Economics:
David Atkins, M.D., M.P.H.
Lynn Bosco, M.D., M.P.H. (Pharmaceuticals)
Darryl Gray, M.D., Sc.D.
Mel Henderson, M.A., M.P.H.
Mary Nix, M.S., MT(ASCP)SBB (National Guideline Clearinghouse™)
Susan Norris, M.D., M.P.H. (Chronic care management)
Gurvaneet Randhawa, M.D., M.P.H.
Scott R. Smith, R.Ph., Ph.D. (Pharmaceuticals)
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Internet Citation:
Research Initiative in Clinical Economics. March 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/rice/
540 Gaither Road Rockville, MD 20850