Should Health Economic Evaluations Undertaken from a Societal Perspective Include Net Government Spending Multiplier...

Area of Science:

• Health Economics
• Public Finance
• Health Technology Assessment

Background:

• Fiscal multipliers measure national income changes from government spending increases.
• Multiplier effects are typically excluded from healthcare economic evaluations.
• Different healthcare spending types may yield varied multiplier effects.

Purpose of the Study:

• To estimate and apply net government spending multiplier effects to two economic evaluations.
• To assess the impact of multiplier effects on the cost-effectiveness of health technologies and services.

Main Methods:

• Estimation of net government spending multiplier effects.
• Application of these multipliers to two published economic evaluations: a pharmaceutical and a healthcare delivery model.
• Societal perspective analysis for economic evaluations.

Main Results:

• A pharmaceutical for cardiovascular disease showed negative net multiplier effects, increasing cost per QALY from AU$31,244 to AU$47,311.
• A healthcare delivery model for frail older people demonstrated positive net multiplier effects, decreasing cost per QALY from AU$8,129 to AU$7,669.
• Crowding-out effects of government healthcare spending were considered low but warrant further investigation.

Conclusions:

• Including net multiplier effects in societal perspective economic evaluations is crucial for accurately determining the value of health technologies and services.
• Multiplier effects can substantially alter cost-effectiveness results, influencing policy and investment decisions.
• Further research into potential crowding-out effects of government healthcare spending is recommended.