Course Syllabus

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Health Economics and Health Policy in Europe

 

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Semester & Location:

Fall 2024 - DIS Copenhagen
Type & Credits:

Elective Course - 3 credits
Major Disciplines:

Public Health, Public Policy
Prerequisite:

None
Faculty Members:

Lone Bilde

(current students please use the Canvas Inbox to contact)
Program contact:

Science and Health Department: shsupport@dis.dk
Program Director:

Susana Dietrich
Time & Place:

Tuesdays and Fridays, 8:30-9:50 in Fi44-Kosmo 405.

 

Faculty

Science-and-Health-Lone-Bilde.jpg

Lone Bilde

M.Sc. (Economics and Languages) 1993, B.Sc. (Economics and Languages), 1988. Postgraduate education in health economics, epidemiology, measurement of health-related quality of life, (bio)statistics as well as coaching and leadership.

Lone is an experienced consultant, advisor and leader of health care research projects. Her area of expertise is health economics, epidemiology, financing, organization, and the management of the health sector, including health economics evaluation. She has carried out several research projects for - and together with - multiple stakeholders in Denmark as well as internationally.

Lone has held senior positions at the Danish Institute for Health Services Research (DSI), the Danish Institute for Local and Regional Government Research (KORA), the Danish Institute for Applied Social Research (VIVE), Novo Nordisk, Nycomed, and the Danish Cancer Society. 

She has been with DIS since December 2022. Lone also teaches the core course: "Healthcare Systems : A Comparative Approach B" and acts as a mentor for semester students working on her research project on nurse job motivation (" retention of nurses in the hospital sector"). 

Course Description

This course provides you with an in-depth look at important concepts and theories in health economics and health policy analysis that will allow you to critically analyze all levels of a healthcare system.

Health economics is a great way to introduce students to the power of economic thinking. You will apply concepts and theories to actual cases from Europe in which health economics rationales clash with health politics. Basic economic appraisals of healthcare interventions and decision analysis of health policy processes are used to analyze current issues in Northern European healthcare systems. The course also provides insight into the practical workings of the public healthcare system in Denmark. Last but not least we will try to find out whether Europe can learn something from the US health care system and vice versa. 

 

Expected Learning Outcomes

After successfully completing this course, you will be able to:

  • Demonstrate a solid knowledge of basic health policy and health economic concepts
  • Explain current issues of financing and decision making in health care in the European healthcare systems
  • Demonstrate basic concepts of different types of economic evaluation, for example, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis
  • Carry out basic health economic appraisals of health care interventions and decision analysis of policy processes 

It is our ambition that the skills acquired in this course will be highly relevant for anyone wishing to pursue further studies and/or a career (political, administrative, or medical) in the health care field.

Pre-requisites 

The course is aimed at everyone with an interest in health care provision and policy and it is especially relevant for students with a focus on public health, human health and disease, economics, and public/social policy. It serves as a good supplement to the "Health Systems - a Comparative Approach" course in the Public Health Program and is also relevant for other programs such as the Medical Practice and Policy and European Politics courses. For Econ majors, some of the microeconomic concepts might be nothing new, but they could still enjoy the refresher and the practical application on health care markets. 

 

Teaching Methods

The course will be based on some lecturing plus a lot of interactive teaching methods.  The learning experience will be enhanced through field studies, guest lectures, real-world case studies, debates, group works etc.  

 

Evaluation and Grading

To be eligible for a passing grade in this class, all of the assigned work must be completed. The factors influencing the final grade and the proportional importance of each factor is shown below:

Component Weight
Participation 20%
Midterm Home Examination 30%

Participation in the debate & debate paper

 20%
Final Home Examination 30%

 

Participation

This is intended to be an interactive class,  primarily because it provides for a better learning experience, but also because it makes classes more fun. In order to participate, students are required to attend all classes, read and prepare before each class, and to participate actively in class. If you are ill, you have to let your teacher know before the class starts. 

Midterm test

You will complete a graded midterm test to give you an idea of your academic level. The mid-term questions will be essay questions that will test your ability of critical thinking. The mid-term test will be a home examination where you are allowed to use materials (scientific articles) besides your class lectures. However, you are not allowed to copy from anywhere including your cohort and your previous cohort.

Debate

You will be assigned to a group where you will have a chance to debate "FOR" or "AGAINST" a pre-defined topic. This is group work and your group will be selected by the course teacher. On the specific date, one person from the group (selected randomly) will present the argument around "FOR" or "AGAINST" the current issue. After the presentation, you will counteract the argument for other gorup. Thereafter, you as a group will write a research paper based on the debate. The debate contains 20% of your mark and is mandatory to attend. There will be an evaluation questionnaire where you will evalute the performance of your group member based on contribution, cooperativeness, attitude etc.

Final test

The final test consists of essay questions and will also be a home examination. You will have the opportunity to choose from a sample of questions and should only answer a specific amount of these. Please note that the final test covers the entire course.

Class room etiquette

A good learning environment requires that everyone is present (physically and mentally), prepared, and participating. Out of respect for both faculty and fellow students, we expect you to be on time and to participate in the full duration of the class.

Laptops and phones in class: You may use your laptop for note‐taking or fact‐checking. Usage of laptops or phones not related to the class is unacceptable, and will reduce your participation grade significantly.

Make-up classes: There are a few open slots for make-up classes in the syllabus. Please note that there may be organized mandatory classes during these time slots.

 

Academic Regulations

Please make sure to read the Academic Regulations on the DIS website. There you will find regulations on: 

 

 

Required Readings

Textbooks

Select chapters form the following books (to be handed out from DIS library)

  • Guinness L & Wiseman V (2011). Introduction to Health Economics. 2nd Berkshire: Open University Press. 
  • Donaldson C & Gerard K (2005). Economics of Health Care Financing - The Visible Hand. 2nd New York: Palgrave Macmillan

On Canvas

  • Arrow KJ (1963). Uncertainty and the welfare economics of medical care. American Economic Review, 53 (5):941-973).
  • Bilde L., Prokupkovà A, Rommel W, Thomsen LA, Ollila E, Kohler D, Sim D (2020): What is a fair price – Cancer leagues’ reflections on what is fair pricing and fair prices of cancer medicines, European Cancer Leagues, Bruxelles, September 2020.
  • Bilde, Lone; Thomas Tjørnelund Nielsen, Finn Rønholt og Marie Kruse (2017): The cost-effectiveness of introducing a vaccine for the prevention of herpes zoster and post-herpetic neuralgia in elderly Danes. Nordic Journal of Health Economics, Vol. 5 (2017), No. 2, pp. 7-27.
  • Brook Robert et al. The Health Insurance Experiment. A classic RAND study speaks to the current health care reform debate. RAND objective analyses and effective solutions. Research Brief. Dec. 6 2006 
  • Di Prete B, Coffman C. A brief history of Health Services Prioritization in Oregon. March 2007 
  • Green-Pedersen C, Wilkerson J (2006). “How agenda-setting attributes shape politics: basic dilemmas, problem attention and health politics developments in Denmark and the US”, Journal of European Public Policy, 13(7):1039–1052.
  • Krasnik A, Groenwegen PP, Pedersen PA et al. (1990). Practice Observed: Changing Remuneration Systems: Effects on Activity in General Practice. BMJ, 300:1698-1701
  • Luellen Eric. Breaking the iron triangle of health. Commentary July 2015. 
  • Olsen KR, Bilde L, Juhl H H, Kjær NT, Mosbech H, Evald T, Rasmussen M, Hiladakis Helle (2006). Cost-effectiveness of the Danish smoking cessation interventions - subgroup analysis based on the Danish smoking cessation database. European Journal of Health Economics, 2006 Dec. 7 (4): 255-64.
  • Robberstad Bjarne. QALYs vs DALYs vs LYs gained: What are the differences, and what difference do they make for health care priority setting? Norsk Epidemiologi 2005; 15 (2): 183-191 
  • Slawomirski, L., Auraaen, A.,  and Klazinga, N. The economics of patient safety. OECD Working paper March 2017 
  • Vallgårda S & Krasnik A (2010). Health services and health policy. Chapter 1: Health Systems Central Concepts and Definitions
  • Vallgårda S & Krasnik A (2010). Health services and health policy. Chapter 2: Health Policy
  • Vallgårda S. (2017) Childhood obesity policies: Mighty concerns, meek reactions. Pediatric Obesity/Public Health 
  • Vallgårda S. (2015). English obesity policies: To govern and not to govern. Health Policy, 119(6), 743-748. 
  • Vrangbaek K in Tikkannen R., Osborn R., Mossailos E., Djordjecic A., Wharthon G. Health Systems in Transition (Chapter on Denmark). Commonwealth Fund 2020
  • Walt G (2005). Making Health Policy. Open University Press. Chapter 4: Agenda setting, page 63-79. 
  • Various texts from The Economist (details to follow)

Supplementary Readings

  • Charlesworth A, Davies A, Dixon J (2012). Reforming payment for health care in Europe to achieve better value.
  • Darvas, Z., Moës, N., Myachenkova, Y., Pichler, D., The macroeconomic implications of healthcare, Bruegel Policy Contribution, issue no. 11, August 2018
  • Drummond M, Sorensen C (2009): Nasty or Nice? A Perspective on the Use of Health Technology Assessment in the United Kingdom, Value in Health, 12(suppl. 2): s8-s13.
  • Freeman R (2000): The health care state in Europe, 1880-1980 (p. 14-31)
  • Helsø, Pierri, Wang: The Economic Impact of Healthcare Quality , IMF working paper WP/19/173, August 2019. 
  • Henry D, Lexchin J (2002). The pharmaceutical industry as a medicines provider. The Lancet, 360:1590-1595.
  • Kristensen FB et al. (2008): What is health technology assessment? In: Garrido MV, Kristensen FB, Nielsen CM, Busse R (eds.) (2008). Health Technology Assessment and Health Policy-Making in Europe. Current status, challenges and potential. Copenhagen: WHO Regional Office for Europe. 31-51
  • Manning WG, Newhouse JP, Duan N, Keeler EB, Leibowitz A. (1987). Health insurance and the demand for health care - Evidence from a randomized experiment.American Economic Review, 77(3):251-277.
  • Ministry of Health  (2017). Ministry of Health (2017). Healthcare in Denmark: An overview.
  • Oberlander, J.: Long Time Coming: Why Health Reform Finally Passed, in Health Affairs,  June 2010 vol. 29 no. 6; 1112-1116.
  • OECD/European Observatory on Health Systems and Policies (2017) Denmark: Country Health Profile 2017 
  • Olejaz M, Juul Nielsen A, Rudkjøbing A, Okkels Birk H, Krasnik A, Hernández-Quevedo C (2012): Denmark - Health system review. Health Systems in Transition. Read the “Executive summary”, page: XVII-XXII.
  • Paul SM et al (2010). How to improve R&D productivity: the pharmaceutical industry’s grand challenge. Nature Reviews: Drug discovery, 9:203-214.
  • Pedersen, K.M., Andersen, J.S., Søndergaard, J. (2012): General Practice and Primary Health Care in Denmark, The Journal of the American Board of Family Medicine · March 2012
  • Porter ME & Lee HE (2013). The strategy that will fix health care. Harvard Business Review, 1-19 
  • Rice et al. (2013): United States of America - Health system review. Read: Executive summary, page: XXI-XXIX.
  • Scharpf FW (1997). Games Real Actors Play, Actor-Centered Institutionalism in Policy Research. Boulder: Westview Press: 1-15 and 36-50.
  • The Economist, Special Report Universal Health Care, April 2018: America is a health-care outlier in the developed world

 Web Resources

 

  DIS - Study Abroad in Scandinavia - www.DISabroad.org

Course Summary:

Date Details Due