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Micro-costing in health and medicine: a critical appraisal

Xiao Xu, Christina M. Lazar and Jennifer Prah Ruger ()
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Xiao Xu: Yale School of Medicine
Christina M. Lazar: Yale School of Medicine
Jennifer Prah Ruger: Perelman School of Medicine, The Leonard Davis Institute of Health Economics, School of Social Policy & Practice, University of Pennsylvania

Health Economics Review, 2021, vol. 11, issue 1, 1-8

Abstract: Abstract Background Concerns about rising health care costs require rigorous economic study to inform clinical and policy decision-making. Micro-costing is a cost estimation methodology employing detailed resource utilization and unit cost data to generate precise estimates of economic costs. Micro-costing studies have not been critically appraised. Methods Critical appraisal of micro-costing studies in English. Studies fully or predominantly employing micro-costing were appraised for methodological and reporting quality through economic evaluation guidelines (Evers, Drummond, Consolidated Health Economic Evaluation Reporting Standards (CHEERS), Fukuda and Imanaka checklists). Following the Panel on Cost Effectiveness in Health and Medicine, micro-costing studies were defined as involving “direct enumeration and costing out of every input consumed in the treatment of a particular patient.” Results Full or predominant micro-costing studies included neoplasms (18.5%), infectious and parasitic diseases (17.9%), and diseases of circulatory systems (10.8%) as the most studied diseases. 36.9% were in the United States and 34.9% were in Europe. 33.8% did not report analytic perspective, 32.8% did not report price year, 3.6% did not inflation adjust cost data, and 44.1% did not specify inflation adjustment. 86.2% did not separately report unit costs and resource utilization quantity, 14.9 and 19.5% did not provide sufficient detail to assess appropriateness of measured physical units or valued costs. Conclusions Micro-costing studies vary widely in methodological and reporting quality, highlighting the need to standardize methods and reporting of micro-costing studies and develop tools for their evaluation.

Keywords: Micro-costing; Economic evaluation; Resource allocation; Health and medicine (search for similar items in EconPapers)
Date: 2021
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DOI: 10.1186/s13561-020-00298-5

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