Cost of illness (COI) studies look at the value of resources expended or forgone as the result of an illness. ‘Illness’ may refer to specific diseases (e.g. cancer), injuries (e.g. motor vehicle accidents), risk factors (e.g. smoking) or groups of health conditions (e.g. sleep disorders).

COI studies have used inconsistent methodologies and findings can be difficult to compare historically and internationally, with many articles in the literature noting the need for more consistent typology. Costs may be calculated with different perspectives, purposes, timeframes or approaches and there is relatively little guidance to assist readers in evaluating methods, leading to some concerns about reliance on the findings. The overarching research question that the dissertation seeks to address is thus:

Given the heterogeneity in COI methods historically, what best practice guidelines and tools can be used in future that could assist interested parties in achieving greater consistency in approach, accuracy of findings and comparability across study results?

The thesis presents methods and findings from a literature review of published articles addressing COI methodology, undertaken to inform the issues encountered and their typical resolution. From this review, a series of propositions were derived and tested using a four-round Delphi panel process, with panel participants recruited globally from authors of previous COI studies and eminent health economists.
Using an anonymous survey, the Delphi process refined and validated the methodological guidelines, which cover aspects including purpose and perspective, cost classification and estimation techniques, incidence and prevalence approaches, timing, discounting, measuring production, efficiency and wellbeing losses, and dealing with uncertainty. The best practice guidelines and tools (a cost matrix, taxonomy and checklist) were applied to a case study to demonstrate their value in enhancing future methodological consistency, accuracy and monitoring of COI studies.

About Lynne

Lynne graduated from the University of Adelaide with 1st class Honours in Economics in 1986. After working for 10 years in the Australian government, she joined Access Economics in 2000, where she built a health economics practice. In 2011, the Access Economics team joined Deloitte, and in that year Lynne became the Lead Partner, Health Economics and Social Policy, for Deloitte Access Economics, and the Managing Partner Canberra for Deloitte Touche Tohmatsu. Lynne’s research and works in health economics and human services now span five continents. Lynne is married and has 4 children, commencing her PhD in 2012.