Evidence on the cost-effectiveness of public health interventions is required in order to demonstrate their priority for public funding. However, the evaluation of public health interventions is complex as many involve multiple decision makers with costs falling across multiple sectors and with wider benefits than health alone. Further, a major aim within public health is not only to improve outcomes but also to reduce health inequalities.
To further develop a framework to allow for the assessment of the cost-effectiveness of public health interventions with impacts on health and non-health outcomes, as well costs falling across different public and private sectors. The framework will combine the objectives of maximising outcome and minimising inequalities. A series of case studies will be developed to compare the framework with alternative approaches.
Methods for estimating the cost-effectiveness of health programmes with costs falling on the NHS are well established. These methods have been extended, based on PHRC-funded work, to combine the objectives of maximising health and minimising health inequalities. Previous work has outlined a framework for extending cost-effectiveness analyses to incorporate health and non-health outcomes and costs falling on the NHS and beyond.This work will continue the development of the framework to consider multiple outcomes and costs falling on different sectors and which incorporates inequality aversion.
Case studies will be developed to apply alternative approaches to economic evaluation to public health interventions. These will include the use of the developed framework and other approaches such as meta-outcomes and cost-benefit analysis. The case studies will explore the practicalities of applying the different methods such as relevant evidence and will examine whether they meet the needs of decision-making.
Finally, a workshop involving economists, public health researchers, public health professionals and local and national decision makers will be organised to present the framework and the case studies using the alternative approaches.