Abstract
BackgroundCost-Effectiveness Analysis (CEA) has been promoted as an important research methodology for determining the efficiency of healthcare technology and guiding medical decision-making. Our aim was to characterize the collaborative patterns of CEA conducted over the past two decades in Spain.Methods and FindingsA systematic analysis was carried out with the information obtained through an updated comprehensive literature review and from reports of health technology assessment agencies. We identified CEAs with outcomes expressed as a time-based summary measure of population health (e.g. quality-adjusted life-years or disability-adjusted life-years), conducted in Spain and published between 1989 and 2011. Networks of coauthorship and institutional collaboration were produced using PAJEK software. One-hundred and thirty-one papers were analyzed, in which 526 authors and 230 institutions participated. The overall signatures per paper index was 5.4. Six major groups (one with 14 members, three with 7 members and two with 6 members) were identified. The most prolific authors were generally affiliated with the private-for-profit sector (e.g. consulting firms and the pharmaceutical industry). The private-for-profit sector mantains profuse collaborative networks including public hospitals and academia. Collaboration within the public sector (e.g. healthcare administration and primary care) was weak and fragmented.ConclusionsThis empirical analysis reflects critical practices among collaborative networks that contributed substantially to the production of CEA, raises challenges for redesigning future policies and provides a framework for similar analyses in other regions.
Highlights
In recent years, rising demand and constrained resources– enhanced by the recent economic and financial crisis–is making cost-effectiveness one of the most important goals in healthcare
Cost-Effectiveness Analysis (CEA) has been promoted as an important research methodology for determining the efficiency of healthcare technology and guiding societal decision-making on the financing of public healthcare services
There is some controversy about the role of CEA in decision-making at the level of healthcare administrations and individual hospitals, various national healthcare systems are using economic evidence to make system-level decisions about which interventions to fund from collective resources [7], with Australia, New Zealand, the United Kingdom and Canada pioneering this scheme [8,9]
Summary
In recent years, rising demand and constrained resources– enhanced by the recent economic and financial crisis–is making cost-effectiveness one of the most important goals in healthcare. CEA has been promoted as an important research methodology for determining the efficiency of healthcare technology and guiding societal decision-making on the financing of public healthcare services. The regulatory and institutional framework has so far not helped the introduction of CEAs and their application to the decisions of public health funding. Such is the case in Spain, where the 2006 Pharmaceuticals and Healthcare Products Law [10] avoided any explicit reference to cost-effectiveness. Cost-Effectiveness Analysis (CEA) has been promoted as an important research methodology for determining the efficiency of healthcare technology and guiding medical decision-making.
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