Health Economics & Health Technology Assessment

The general objectives of the department are to establish a high quality scientific research programme, to provide adequate training in Health Economics and Health Technology Assessment (HTA) in the Bachelor and Master programmes of Health Sciences, and to offer methodological support and advice concerning Health Economics and HTA studies. The main tasks are research and education, but consultation is also important.
Research is conducted in close collaboration with the HTA department of the Institute for Research in Extramural Medicine (EMGO) of the VU University Medical Center and with the department of General Economics of the VU University Amsterdam.

Health economics

Should hospital managers invest in expensive medical equipments or, instead, hire additional nurses? Will the government levy an additional tax to reduce the use of tobacco? What will be the consequences of the new Dutch health care system on the delivery and quality of health care? Why has the government decided to reform the disability insurance system? All these issues are issues that can be solved using the framework of Health Economics. This framework helps in understanding the motives and behaviour of health care suppliers (e.g. hospitals), insurers and patients. Thus, health professionals become better equipped to take decisions, and to design and assess policies. Presumably, this is the main reason of the up-rise and the success of Health Economics during the last decades.
Health Economics is concerned with the optimal use of scarce health care resources. This requires a thorough understanding of the market for health care at the level of individual customers, health organizations, and the economy as a whole. The analysis is complicated by the multiple specificities of the health care sector, such as the considerable role of uncertainty, the availability of insurance, equity issues or the massive governmental intervention. Health Economics provides a thorough analysis of the market for health care that takes into account these specificities.
Major topics in the field are:

  • The development of valid and reliable measures of health
  • Identifying and understanding the determinants of health
  • Identifying and understanding the determinants of the demand for health care (inclusive private and public insurance)
  • Identifying and understanding the determinants of the supply of health care by profit and non-profit health care organizations
  • Understanding how patients, health care insurers, health care providers and health care officials interact in terms of use and delivery of health care.
  • Understanding the role of uncertainty in health, and the need for insurance that results from this
  • The microeconomic evaluation of alternatives ways of delivering care 
  • The evaluation of the whole health sector in terms of equity, efficiency and effectiveness criteria

The instruments and theories used in Health Economics are commonly standard economic and econometric concepts, but the field has also contributed substantially to the mainstream discipline by designing theories and methodologies that are more adapted to the specificities of the health sector.
In short, Health Economics is essential for a thorough understanding and critical assessment of the health care market and is therefore a must for students who are interested in policy-oriented jobs by national or international health organizations or by the government.

Health Technology Assessment

Over the past decades, the rising cost of health care has increased the importance of HTA to support decisions about the utilization of resources. Questions have been raised as to whether the allocation of resources has led to an optimal gain in total health at population level.
HTA is a form of scientific research that systematically examines short and long-term consequences of the application of a health technology, a set of related technologies or a technology-related issue. Not only are the consequences expressed in terms of clinical efficacy and effectiveness, but other aspects are also considered (e.g. costs, ethical and legal aspects). HTA can cover a broad range of technologies, including new or existing preventive, diagnostic and therapeutic interventions, and is characterized by its multidisciplinary and comprehensive nature. The goal of HTA is to provide objective, valid and reliable information to implement the results of research in daily practice and to provide input for decision-making concerning health policies.
HTA has a broad perspective, and has some overlap with other research sectors such as epidemiology. What is specific for HTA is economic evaluation. The main focus of HTA at the Institute of Health Sciences is on economic evaluations conducted alongside randomized controlled trials of preventive and therapeutic interventions. The reason for this focus is the availability of ample knowledge and expertise in the field of intervention studies. In addition to economic evaluations, HTA also includes systematic reviews on the effectiveness of diagnostic and therapeutic interventions (within the framework of the Cochrane Collaboration), the development of evidence-based guidelines, and evaluation of the implementation of guidelines.
Major research topics:

  • Back pain and other musculoskeletal disorders
  • Diabetes and overweight
  • Depression
  • Lifestyle programmes
  • Systematic review methodology