Assessing the costs and outcomes of healthcare
Healthcare costs are rising across the EU, and the burden is likely to intensify in future with the cost of caring for people with mental health diseases set to increase. Researchers in the PECUNIA project are developing new, more systematic, harmonised and comparable methods of assessing healthcare interventions, which could in future lead to more optimised, cost-effective care, as Professor Judit Simon explains. Many European countries
spend a significant proportion of national income on healthcare, and the financial burden is set to increase further in future, with the cost of mental healthcare likely to lead to significant strain on healthcare organisations. The outlook is set to further worsen, with the COVID-19 pandemic expected to have longterm consequences on mental health amongst the general public. With governments and healthcare organisations looking to control costs while at the same time providing highquality care, it’s important to rigorously assess the costs and effects of different interventions, a topic at the heart of the PECUNIA project. “This project is addressing the issue of increasing healthcare costs,” says Judit Simon, Professor of Health Economics at the Medical University of Vienna, the coordinator of the project. Healthcare costs currently account for about 10 percent of national income across EU countries, the second highest government spending category after social protection, which Professor Simon says is the result of an enormous increase in demand for care, along with the availability and cost of new technologies. “We need this cost-effectiveness information, derived from economic evaluations, in order to provide more efficient
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care across healthcare systems and achieve the best value care possible,” she continues.
PECUNIA project This is an issue Professor Simon and her colleagues from six European countries in the project are working to address by establishing a standardised approach to assessing the impact of healthcare interventions in the EU. Currently, there are not really any tools available to compare the results of economic evaluations conducted in different countries, while Professor Simon is also considering the wider importance of health in the project. “The EU published a strategy document several years ago which states that health is not just a value in itself, but is also very important for economic growth and prosperity,” she explains. The ongoing COVID-19 pandemic illustrates the importance of public health to the wider economy, but the so-called inter-sectoral consequences of healthcare interventions are often not considered in economic evaluations. “In these evaluations the health and social care costs of interventions and consequences are commonly measured, but very often healthcare interventions have a wider impact, for example on our opportunities to work and study,” points out Professor Simon.
The wider aim in the project is to develop methods and tools that enable such multisectoral, multi-national and multi-person economic evaluations, focusing in particular on mental healthcare. A mental healthcare intervention doesn’t affect just the individual concerned, but also their families and the people that care for them, while it also has an influence on the opportunities that may be open to them in future. “The treatment costs are the direct costs of healthcare, while these inter-sectoral costs fall outside the healthcare sector. For example, people may be unable to work, or to finish their studies, or there may be legal consequences,” explains Professor Simon. Researchers now aim to consider these types of costs in the project and build a deeper picture of the impact of different healthcare interventions, work which is by nature comparative. “Economic evaluations are comparative – for example you compare the cost of ‘no treatment’ to the cost of ‘treatment’, or you compare an existing medication which is already on the market and is commonly used to a newly developed medication, or you want to focus on comparing the consequences of prevention and early intervention options with different treatment options,” outlines Professor Simon.
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