Planning a health economic evaluation (PICO)

There are some important methodological aspects that one should consider when undertaking an economic evaluation. This is one the basis of a PICO: Patient/Population – Intervention – Comparator – Outcome. It is useful, however not necessary, to have some initial thoughts about the PICO of your study before entering into a meeting with us.

Patient/Population:

• Who is the patient/population your research question is focused on?
  • E.g. Age, sex, diagnosis, primary problem, health status

Intervention:

• What is the intended action, method or activated process to expose the patients/population to?

Comparator:

• What does your intervention/method intends to displace or be compared with, if anything it all?
• What evidence is available on costs and effects?

Outcome:

• What is the intended purpose of the intervention/method?
• What is the desired result of the intervention/method?

Another important aspect to decide upon is choosing the study perspective: the point of view the economic evaluation should evaluate. This is important as it determines which costs and effects are relevant to your study and what should be captured. For example, the reduction of psychiatric hospital beds might seem cost-effective from the perspective of the health care sector, but less so from that of society as a whole, including patients’ or carers’ perspectives.

Typical viewpoints are those of:

• the health care provider – for example, a hospital
• the health system
• the society as a whole, with for example including productivity loss of patients