Novel economic perspectives on prevention and treatment : case studies for paediatric, adolescent and adult infectious and chronic diseases

Conventional economic evaluations mainly address the issue of health care service budget efficiency and they seldom quantify wider consequences. The latter include a variety of externalities, the impact of diseases on cognition and school performance as well as behavioural effects that may alter economic decisions. Approaching economic evaluations in health care from a broad perspective that accounts for a considerable proportion of the broader health benefits and externalities, requires a new conceptualization and new methods for the quantification of benefits.

In Part I of this Thesis a quantitative analytic methodological framework for assessing the government perspective or fiscal impact of health conditions and the fiscal benefits of therapeutic interventions and immunizations, is presented. Part II of this Thesis applies the method to paediatric, adolescent and adult vaccinations. Part III aims to quantify the broader benefits of treating ADHD in Germany.

Originating from the observed gap between micro and macro estimates attributed to health and the subsequent challenges this gap presents to our understanding of health-related productivity changes and consequently economic benefits, a critique of the existing methodologies was conducted.

Subsequently, it is proposed that there is a transitional domain that links the microeconomic and macroeconomic improvement attributed to health status changes. Notwithstanding the caveats and practical challenges of conducting a broader economic analysis, it is suggested that broadening the benefits that are taken into account in an economic evaluation, will make it more likely that health interventions with wider benefits and/or externalities will be selected for implementation.