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The evaluation of lifestyle interventions in the Netherlands

Published online by Cambridge University Press:  02 March 2012

David R. Rappange
Affiliation:
Researcher, Department of Health Policy & Management, Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
Werner B. F. Brouwer*
Affiliation:
Professor of Health Economics, Department of Health Policy & Management, Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
*
*Correspondence to: Werner B.F. Brouwer, Department of Health Policy & Management, Institute for Medical Technology Assessment, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands. Email: [email protected]

Abstract

Current investments in preventive lifestyle interventions are relatively low, despite the significant impact of unhealthy behaviour on population health. This raises the question of whether the criteria used in reimbursement decisions about healthcare interventions put preventive interventions at a disadvantage. In this paper, we highlight the decision-making framework used in the Netherlands to delineate the basic benefits package. Important criteria in that framework are ‘necessity’ and ‘cost-effectiveness’. Several normative choices need to be made, and these choices can have an important impact on the evaluation of lifestyle interventions, especially when making these criteria operational and quantifiable. Moreover, the implementation of the decision-making framework may prove to be difficult for lifestyle interventions. Improvements of the decision-making framework in the Netherlands are required to guarantee sound evaluations of lifestyle interventions aimed at improving health.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012

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References

Avenell, A., Broom, J., Brown, T. J., Poobalan, A., Aucott, L., Steran, S. C., Smith, W. C., Jung, R. T., Campbell, M. K.Grant, A. M. (2004), ‘Systematic review of the long-term effects and economic consequences of treatments of obesity and implications for health improvement’, Health Technology Assessment, 8(iii–iv): 1182.CrossRefGoogle ScholarPubMed
Bobinac, A., van Exel, N. J. A., Rutten, F. F. H.Brouwer, W. B. F. (2010), ‘Willingness to pay for a QALY: the individual approach’, Value in Health, 13(8): 10461055.CrossRefGoogle Scholar
Bobinac, A., van Exel, N. J. A., Rutten, F. F. H.Brouwer, W. B. F. (2011a), ‘Get more, pay more? An elaborate test of the validity of willingness to pay per QALY estimates’, Journal of Health Economics, doi:10.1016/j.jhealeco.2011.09.004.Google ScholarPubMed
Bobinac, A., Brouwer, W. B. F.van Exel, N. J. A. (2011b), ‘Societal discounting and growing healthy life expectancy – an empirical investigation’, Health Economics, 20(1): 111119.CrossRefGoogle Scholar
Brouwer, W. B. F. (2009), ‘The Basis of the Package’. Inaugural lecture, Erasmus University Rotterdam.Google Scholar
Brouwer, W. B. F., Rutten, F. F. H.Koopmanschap, M. A. (2001), ‘Costing in Economic Evaluations’, in M. F. Drummond and A. McGuire (eds), Economic Evaluation in Health Care: Merging Theory with Practice, New York: Oxford University Press.Google Scholar
Brouwer, W. B. F., Niessen, L. W., Postma, M. J.Rutten, F. F. H. (2005), ‘Need for differential discounting of costs and health effects in cost effectiveness analyses’, British Medical Journal, 331: 446448.CrossRefGoogle ScholarPubMed
Brouwer, W. B. F., van Exel, N. J. A., van Baal, P. H. M.Polder, J. J. (2007), ‘Economics and public health: engaged to be happily married!’, European Journal of Public Health, 17: 122123.CrossRefGoogle Scholar
Brouwer, W. B. F., van Exel, N. J. A., Baker, R.Donaldson, C. (2008), ‘The new myth: the social value of a QALY’, PharmacoEconomics, 26: 14.CrossRefGoogle ScholarPubMed
CBO (Dutch Institute for health care improvement) (2009), ‘Guideline Treatment of Tobacco Dependence’. Revision 2009. Available at: http://www.cbo.nl/Downloads/836/Richtlijn%20Tabaksverslaving%20definitief.pdf [in Dutch].Google Scholar
Claxton, K., Paulden, M., Gravelle, H., Brouwer, W. B. F.Culyer, A. J. (2011), ‘Discounting and decision making in the economic evaluation of health-care technologies’, Health Economics 20: 215.CrossRefGoogle ScholarPubMed
Claxton, K., Sculpher, M.Drummond, M. (2002), ‘A rational framework for decision making by the National Institute for Clinical Excellence (NICE)’, Lancet, 360: 711715.CrossRefGoogle ScholarPubMed
Committee on Choices in Health Care (Dunning Committee) (1992), Choices in Health Care, Rijswijk, the Netherlands: Ministry of Welfare Health and Cultural Affairs.Google Scholar
CVZ (Health Care Insurance Board) (2006), Package Management in Practice, Diemen: CVZ, [in Dutch].Google Scholar
CVZ (Health Care Insurance Board) (2009a), Package Management in Practice 2, Diemen: CVZ, [in Dutch].Google Scholar
CVZ (Health Care Insurance Board) (2009b), Smoking Cessation Program: Care to be Insured, Diemen: CVZ, [in Dutch].Google Scholar
de Bekker-Grob, E. W., Polder, J. J., Mackbach, J. P.Meerding, W. J. (2007), ‘Towards a comprehensive estimate of national spending on prevention’, BMC Public Health, 7: 252.CrossRefGoogle ScholarPubMed
de Wit, A.Brouwer, W. B. F. (2004), ‘Economische evaluaties van GVO programma's: Belangrijk, lastig, en te weinig gedaan’, Tijdschrift voor Gezondheidswetenschappen, 82: 129132 [in Dutch].Google Scholar
Dirkmaat, T., van Genugten, M. L. L.de Wit, G. A. (2003), Cost Effectiveness of Prevention – an Exploratory Study, Bilthoven, the Netherlands: National Institute for Public Health and the Environment (RIVM), [in Dutch, English abstract].Google Scholar
Dranove, D. (2003), What's Your Life Worth?, New Jersey: FT/Prentice-Hall.Google Scholar
Drummond, M. F., Sculpher, M. J., Torrance, G. W., O'Brian, B. J.Stoddart, G. L. (2005), Methods for the Economic Evaluation of Health Care Programmes, 3rd edition, New York: Oxford University Press Inc.CrossRefGoogle Scholar
Eichler, H.-G., Kong, S. X., Gerth, W. C., Mavros, P.Jönsson, B. (2004), ‘Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness tresholds expected to emerge?’, Value in Health, 7: 518528.CrossRefGoogle Scholar
Elley, R., Kerse, N., Arroll, B., Swinburn, B., Ashton, T.Robinson, E. (2004), ‘Cost-effectiveness of physical activity counseling in general practice’, New Zealand Medical Journal, 117(1207): U1216.Google ScholarPubMed
Feenstra, T. L., Hamberg-van Reenen, H. H., Hoogenveen, R. T.Rutten-van Molken, M. P. (2005), ‘Cost-effectiveness of face-to-face smoking cessation interventions: a dynamic modelling study’, Value in Health, 8: 178190.CrossRefGoogle Scholar
Feenstra, T. L., van Baal, P. H. M., Gandjour, A.Brouwer, W. B. F. (2008), ‘Future costs in economic evaluation: a comment on Lee’, Journal of Health Economics, 27: 16451649.CrossRefGoogle ScholarPubMed
Garber, A. M.Phelps, C. E. (1997), ‘Economic foundations of cost-effectiveness analysis’, Journal of Health Economics, 16: 131.CrossRefGoogle ScholarPubMed
Gravelle, H.Smith, D. (2001), ‘Discounting for health effects in cost-benefit and cost-effectiveness analysis’, Health Economics, 10: 587599.CrossRefGoogle ScholarPubMed
Gravelle, H., Brouwer, W. B. F., Niessen, L. W., Postma, M. J.Rutten, F. F. H. (2007), ‘Discounting in economic evaluations: stepping forward towards optimal decision rules’, Health Economics, 16: 307317.CrossRefGoogle ScholarPubMed
Haslam, D. W.James, W. P. T. (2005), ‘Obesity’, Lancet, 366: 11971209.CrossRefGoogle ScholarPubMed
Herman, W. H., Hoerger, T. J., Brandle, M., Hicks, M., Sorensen, S., Zhang, P., Hamman, R. F., Ackermann, R. T., Engelgau, M. M.Ratner, R. E., Diabetes Prevention Program Research Group (2005), ‘The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance’, Annals of Internal Medicine, 142: 323332.CrossRefGoogle ScholarPubMed
Hirth, R. A., Chernew, M. E., Miller, E., Fendrick, A. M.Weissert, W. G. (2000), ‘Willingness to pay for a quality-adjusted life year: in search of a standard’, Medical Decision Making, 20: 332342.CrossRefGoogle ScholarPubMed
Hollander, A. E. M., de Hoeymans, N., Melse, J. M., van Oers, J. A. M.Polder, J. J. (2006), Public Health Forecast 2006, Houten, the Netherlands: Bohn Stafleu Van Loghum, [in Dutch, English abstract].Google Scholar
Johannesson, M. (2001), ‘Should we aggregate relative or absolute changes in QALYs?’, Health Economics, 10: 573577.CrossRefGoogle ScholarPubMed
Johansson, S. E.Sundquist, J. (1999), ‘Change in lifestyle factors and their influence on health status and all-cause mortality’, International Journal of Epidemiology, 28: 10731080.CrossRefGoogle ScholarPubMed
Jonson, A. R. (1986), ‘Bentham in a box: technology assessment and health care allocation’, Law, Medicine & Health Care, 14: 172174.CrossRefGoogle Scholar
Keeler, E. B.Cretin, S. (1983), ‘Discounting of life-saving and other non-monetary effects’, Manage Science, 29: 300306.CrossRefGoogle Scholar
Koopmanschap, M. A., Rutten, F. F. H., van Ineveld, B. M.van Roijen, L. (1995), ‘The friction cost method for measuring indirect costs of disease’, Journal of Health Economics, 14: 171189.CrossRefGoogle ScholarPubMed
Mackenbach, J. M. (2010), Disease in the Netherlands. Health Between Politics and Biology, Amsterdam: Elsevier Gezondheidszorg, [in Dutch].Google Scholar
McCabe, C., Claxton, K.Culyer, A. J. (2008), ‘The NICE cost-effectiveness threshold: what it is and what that means’, PharmacoEconomics, 26: 733744.CrossRefGoogle ScholarPubMed
Meltzer, D. (1997), ‘Accounting for future costs in medical cost-effectiveness analysis’, Journal of Health Economics, 16: 3364.CrossRefGoogle ScholarPubMed
Meltzer, D.Johannesson, M. (1999), ‘Inconsistencies in the “societal perspective” on costs of the panel on cost-effectiveness in health and medicine’, Medical Decision Making, 19: 371377.CrossRefGoogle ScholarPubMed
Mitton, C.Donaldson, C. (2004), ‘Health care priority setting: principles, practice and challenges’, Cost Effectiveness and Resource Allocation, 2: 3. Available at: http://www.resource-allocation.com/content/2/1/3CrossRefGoogle ScholarPubMed
Nord, E. (2005), ‘Concerns for the worse off: fair innings versus severity’, Social Science & Medicine, 60: 257263.CrossRefGoogle ScholarPubMed
Nyman, J. A. (2004), ‘Should the consumption of survivors be included as a cost in cost-utility analysis?’, Health Economics, 13: 417427.CrossRefGoogle Scholar
Lee, R. H. (2008), ‘Future costs in cost effectiveness analysis’, Journal of Health Economics, 27: 809818.CrossRefGoogle ScholarPubMed
Organisation for Economic Co-operation and Development (OECD) (2005), Health at a Glance: OECD Indicators 2005, Paris: OECD Publishing.Google Scholar
Rappange, D. R., Brouwer, W. B. F., Rutten, F. F. H.van Baal, P. H. M. (2010), ‘Lifestyle intervention: from cost savings to value for money’, Journal of Public Health, 32: 440447.CrossRefGoogle ScholarPubMed
Rappange, D. R., van Baal, P. H. M., van Exel, N. J. A., Feenstra, T. L., Rutten, F. F. H.Brouwer, W. B. F. (2008), ‘Unrelated medical costs in life-years gained: should they be included in economic evaluations of healthcare interventions?’, PharmacoEconomics, 26: 815830.CrossRefGoogle ScholarPubMed
Rawlins, M. D.Culyer, A. J. (2004), ‘National institute for clinical excellence and its value jugdements’, British Medical Journal, 329: 224227.CrossRefGoogle Scholar
Ronckers, E. T., Groot, W.Ament, A. J. H. A. (2005), ‘Systematic review of economic evaluations of smoking cessation: standardizing the cost-effectiveness’, Medical Decision Making, 25: 437448.CrossRefGoogle ScholarPubMed
RVZ (Council for Public Health and Care) (2006), Sensible and Sustainable Care, The Hague: RVZ, [in Dutch].Google Scholar
RVZ (Council for Public Health and Care) (2007), Fair and Sustainable Care, The Hague: RVZ, [in Dutch].Google Scholar
Saha, S., Gerdtham, U.-G.Johansson, P. (2010), ‘Economic evaluation of lifestyle interventions for preventing diabetes and cardiovascular diseases’, International Journal of Environmental Research and Public Health, 7: 31503195.CrossRefGoogle ScholarPubMed
Schreyögg, J., Stargardt, T., Velasco-Garrido, M.Busse, R. (2005), ‘Defining the “health benefit basket” in nine european countries: evidence from the European Union Health BASKET project’, European Journal of Health Economics, 6, (Supplement 1): 210.CrossRefGoogle Scholar
Statistics Netherlands (CBS) (2004), Health Accounts 2003, Voorburg, the Netherlands: Statistic Netherlands, [in Dutch].Google Scholar
Stolk, E. A., Brouwer, W. B. F.van Busschbach, J. J. V. (2002), ‘Rationalising rationing: economic and other considerations in the debate about funding of Viagra’, Health Policy, 59: 5363.CrossRefGoogle ScholarPubMed
Stolk, E. A., van Donselaar, G., Brouwer, W. B. F.van Busschbach, J. J. V. (2004), ‘Reconciliation of economic concerns and health policy: illustration of an equity adjustment procedure using proportional shortfall’, PharmacoEconomics, 22: 10971107.CrossRefGoogle ScholarPubMed
Stolk, E. A., Pickee, S. J., Ament, A. H. J. A.Busschbach, J. J. V. (2005), ‘Equity in health care prioritisation: an empirical inquiry into social value’, Health Policy, 74: 343355.CrossRefGoogle ScholarPubMed
Stolk, E. A., de Bont, A., van Halteren, A. R., Bijlmer, R. J.Poley, M. J. (2009), ‘Role of health technology assessment in shaping the benefits package in the Netherlands’, Expert Reviews of Pharmacoeconomics & Outcomes Research, 9: 8594.CrossRefGoogle ScholarPubMed
van Baal, P. H. M., Feenstra, T. L., Hoogenveen, R. T., de Wit, G. A.Brouwer, W. B. F. (2007), ‘Unrelated medical care in life years gained and the cost utility of primary prevention: in search of a “perfect” cost-utility ratio’, Health Economics, 16: 421433.CrossRefGoogle ScholarPubMed
van Baal, P. H. M., Polder, J. J., Hoogenveen, R. T., Engelfriet, P. M., Boshuizen, H. C., Feenstra, T. L., de Wit, G. A.Brouwer, W. B. F. (2008), ‘Prevention no cure for rising expenditures: lifetime medical costs of obesity’, PLoS Medicine, 5(2): e29 (0242–0249).CrossRefGoogle Scholar
Vijgen, S. M. C., Busch, M. C. M., de Wit, G. A., van Zoest, F.Schuit, A. J. (2005), Economic Evaluation of Prevention – Opportunities for Dutch Public Health Policy, Bilthoven, the Netherlands: National Institute for Public Health and the Environment (RIVM), [in Dutch, English abstract].Google Scholar
VWS (Ministry of Health Welfare and Sport) (2006), ‘Prevention Note Choosing for a Healthy Life’. Available at http://www.rijksoverheid.nl/documenten-en-publicaties/brochures/2007/01/31/preventienota-kiezen-voor-gezond-leven.html [15 January 2012] [in Dutch].Google Scholar
Weinstein, M. C.Stason, W. B. (1977), ‘Foundations of cost-effectiveness analysis for health and medical practices’, New England Journal of Medicine, 296: 716721.CrossRefGoogle ScholarPubMed
Williams, A. (1997), ‘Intergenerational equity: an exploration of the fair innings argument’, Health Economics, 6: 117132.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
WHO (World Health Organization) (2011), ‘Global status report on noncommunicable diseases 2010’. Available at: http://whqlibdoc.who.int/publications/2011/9789240686458_eng.pdf [12 May 2011].Google Scholar