Course catalogue doctoral education - HT20

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Title Global Health Economics
Course number 3196
Programme Infektionsbiologi och global hälsa (BIGH)
Language English
Credits 3.0
Date 2019-09-30 -- 2019-10-11
Responsible KI department Institutionen för global folkhälsa
Specific entry requirements Students must be familiar with the basics of health economics.
Purpose of the course The aim of this course will be to learn how health care systems are financed around the world, the principles of Universal Health Coverage (UHC) and financial protection and how it can be measured. Different perspectives of economic evaluations and the four most common types of health economic analysis (cost analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis) will be described and brief introduction to modeling in health economics will be given. It will also focus on the unique challenges found in performing economic evaluations in low and middle income countries (LMICs) such as validated tools to collect effectiveness/utility measurements and collecting cost data. The course will also provide an introduction to behavioral economics and its potential role in public health policy.
Intended learning outcomes At the end of the course the students will be able to:

- Describe different kinds of health care financing systems around the world
- Describe and discuss the definitions, key methods, measurements and indicators of UHC, financial protection and patient costs (out-of-pocket (OOP) expenditures, opportunity costs and catastrophic costs)
- Explain different perspectives for economic evaluations (health care system, government, third party payer, societal, etc)
- Describe common health economic evaluation methods.
- Explain advantages and disadvantages with the different methods and discuss which method that would be preferable in different low and middle income settings.
- Critically assess different tools to collect effectiveness and utility measurements
- Independently write a plan for a health economic evaluation of a specific intervention in health care.
- Understand the basic principles of health economic modeling
- Describe different kinds of socio-economic outcomes related to patient costs
- Explain key behavioral economics concepts that are most relevant for public health policy
Contents of the course Health economics is the use of economic theory and methodology to analyze how scarce resources are used in the health sector and in relation to health. OOP spending and opportunity costs is increasingly recognized as an important barrier to accessing health care, particularly in LMICs where a large portion of health expenditure comes from OOP payments and social safety net systems are often weak. Emerging UHC policies prioritize reduction of poverty impact such as catastrophic and impoverishing healthcare costs. Poverty impact is therefore increasingly evaluated alongside and within economic evaluations to estimate the impact of specific health interventions on poverty.

In addition, the course will explore and describe the main kinds of health economic perspectives and evaluations (i.e. cost analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis) and the challenges that are unique to LMIC settings when it comes to conducting health economic evaluations. This course will highlight methodological challenges in collecting effectiveness/utility and cost data in LMIC contexts. For example, where routine cost data are unavailable, economic evaluations in LMICs require extensive primary cost data collection. The course will also give an introduction to how modeling techniques can be used in health economics.
The basic assumptions in neoclassical economics (e.g. individuals act to maximize their long-term interest, have stable preferences, and are consistent rational actors) has served as an important foundation in predicting behavior. In the past, this model has influenced the design of public health policy, specifically around risk perceptions (gruesome images on cigarette packages), taxing harmful substances like tobacco and alcohol, and subsidizing preventive care (e.g. vaccinations). However, these traditional economic incentives sometimes prove ineffective. Behavioral economics differs from mainstream economics in that it focuses on the ways in which rationality may be limited or bounded, and influenced by factors such as impulsiveness, limited willpower, social norms, and the context in which choices are made. The course will provide an introduction to behavioral economics and its potential role in public health policy.

The course provides training in health economic analyses and presentations, both written and oral.
Teaching and learning activities The course will have a blended learning approach with the combination of face-to-face lectures, online practical assignments/discussions, self-study and oral presentations and a final written economic evaluation plan. Face-to-face lectures and other activities will be conducted once a week for a period of four weeks. Once a week lectures will allow the students to reflect on the given material and to apply this new knowledge to the practical assignments. Practical assignments in the form of discussions and exercises will be discussed with the group (if applicable online) and peer feedback will be given. Teaching is given in English.
Compulsory elements Participation in the online practical assignments, the final written economic evaluation plan, giving feedback on peer proposal plans and participation in the final discussion will be mandatory.
Examination Course assignments, oral presentation and take home examination (the final written economic evaluation plan) will be graded as fail or pass. In order to pass the course, the student need to pass the assignments and the take home examination. The course assignments will guide the students through the steps needed to design a health economic study. The aim of the examination is to test the students on what they have learned over the duration of the course and how well they can apply it. The take home exam will have to be submitted through the KI online learning platform one week after the end of the course.
Literature and other teaching material Drummond MF (ed.). Methods for the Economic Evaluation of Health Care Programmes. Oxford: Oxford university press, latest edition.

Morris, S.; Morris, S. Economic analysis in health care. 2nd ed. : Chichester : John Wiley & Sons, 2012. ISBN:978-1-119-95149-0 (paper : alk. paper) LIBRIS-ID:12746972

Recommended Reading:
Griffiths UK, Legood R, Pitt C. Comparison of Economic Evaluation Methods Across Low-income, Middle-income and High-income Countries: What are the Differences and Why? Health Econ. 2016 Feb;25 Suppl 1:29-41. doi: 10.1002/hec.3312. Epub 2016 Jan 17.

Sweeney S, Vassall A, Foster N, Simms V, Ilboudo P, Kimaro G, et al. Methodological Issues to Consider When Collecting Data to Estimate Poverty Impact in Economic Evaluations in Low-income and Middle-income Countries. Health Econ. 2016 Feb;25 Suppl 1:42¿52.

Tracking Universal Health Coverage: 2017 Global Monitoring Report: 2017/en/

World Social Protection Report 2017-2019: g--en/index.htm
Number of students 8 - 20
Selection of students Eligible doctoral students, with required prerequisite knowledge, will be selected based on 1) the relevance of the course syllabus for the applicant's doctoral project (according to written motivation), 2) date for registration as a doctoral student (priority given to earlier registration date).
More information The course will be held on the Solna Campus.
Additional course leader Birger Forsberg ( will also be responsible for the course.
Latest course evaluation Not available
Course responsible Kristi Sidney Annerstedt
Institutionen för global folkhälsa
Contact person Kristi Sidney Annerstedt
Institutionen för global folkhälsa