Basic principles of health technology assessment, economic evaluation, and costing of healthcare programs

Finding the equilibrium between raising demand for healthcare services and increasing cost containment pressures needed to guarantee the sustainability is the main challenge of healthcare systems around the world. In this context, health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Economic evaluation analysis is one of the main pillars of a broader evaluative framework: health technology assessment (HTA) which refers to the systematic evaluation of properties, effects, and/or impacts of health technology. The traditional classification of economic evaluation includes cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. This chapter introduces readers to the basic pillars of HTA, its processes, and briefly explains the differences between cost-effectiveness analysis (used when the outcomes may vary, but can be expressed in common natural units), cost-utility analysis (used when outcomes do vary—for example, quality of life scales), and cost-benefit analysis (used when a monetary value is being placed on services received). The aim is to provide a very introductory overview of these concepts which have been extensively described in the literature.