Abstract
Burden of disease and comparative risk assessment studies describe what the current burden (disability-adjusted life-years; DALYs) is, and how much is due to risk factors like tobacco and excess body weight. But they do not tell us the impact on this burden from actual interventions, and what interventions might be most cost-effective (or cost-saving).To achieve this later objective, epidemiological and economic simulation can be used.
Both Australia and NZ have undertaken many such simulations for preventive (and other) interventions using multi-state lifetable models in the Australian Assessing Cost-Effectiveness (ACE) and NZ Burden of Disease Epidemiology, Equity and Cost-Effectiveness (BODE3) Programmes, and related projects.This presentation will cover:
- an overview of the BODE3 approach using tobacco tax as an example, and illustrate the importance of extensions to include: health gains and costs by time horizon; heterogeneity (e.g. the impact on Māori:non-Māori health inequalities).
- summarising multiple evaluations in online interactive league tables, allowing the user to rank comparable interventions by health gains (QALYs, DALYs), costs and cost-effectiveness.
- an excess costing approach to generate health system costs by disease (and in due course productivity costs), using regression models on NZ full-population linked data. Could this approach supersede stand-alone cost of illness studies?
- our experience with adapting our results using the CBAxtool developed by Treasury.
Blurb
Tony is an epidemiologist, with appointments at both the University of Otago, Wellington (where he directs the BODE3 programme), and University of Melbourne. His current research focus is in two areas:
- Epidemiological and cost-effectiveness modelling of preventive interventions, with extensions such as morbidity and productivity cost impacts around the retirement age.
- Application of counterfactual and potential outcomes approaches in epidemiology, especially causal mediation methods.
Nick is a professor of public health who co-directs (with Tony) the Health Research Council funded BODE3 Programme, University of Otago, Wellington. He is currently working on modelling cardiovascular disease preventive interventions.
Note: Papers, presentation slides and any other material provided by the Guest Lecturer will be made available some time after the lecture.