The 7th annual Vancouver Health Economics Methodology (VanHEM) meeting took place on June 16 in Vancouver, Canada. This one-day conference brings together health economists from across the Pacific Northwest, including Vancouver, Washington State, and Calgary. This has always been more than a Vancouver meeting, which led Anirban Basu from Washington State to suggest changing the name of the meeting to the Cascadia Health Economics Workshop (CHEW) – a definite improvement.
This year’s event began a day early, with Richard Grieve from the London School of Hygiene and Tropical Medicine, Stephen O’Neill from NUI Galway, and Jasjeet Sekhon from the University of California Berkeley, delivering a workshop titled Methods for Addressing Confounding in Comparative Effectiveness and Cost-effectiveness Studies. This provided both theoretical and practical examples of propensity score matching, genetic matching, difference-in-difference estimation and the synthetic control method. I was fortunate enough to be one of the 16 attendees (it was oversubscribed) to participate after being unable to attend when the course was offered at the Society for Medical Decision Making conference this past October. The course was an excellent introduction to these methodologies, including both theoretical and empirical examples of their use. I was particularly interested to have R and Stata code provided, to work through real-world examples. Being able to see the data and code and explore different analyses provided an incredibly rich learning experience.
The following morning, Prof Grieve delivered the plenary address to the more than 80 attendees. This talk discussed the potential for causal inference and large-scale data to influence policy, and outlined how observational data can complement evidence from randomized controlled trials (the slides are available here [PDF]). Since the expertise of our health economics community centres on other methods, primarily economic evaluation and stated preference methods, Prof Grieve’s plenary catalyzed a lot of discussion, which continued throughout the day. After the plenary, there were eight papers discussed over four parallel sessions, in addition to ten posters presented over lunch. This included an interesting paper by Nathaniel Hendrix from Washington state on a mapping algorithm between a generic and condition-specific quality-of-life measure for epilepsy, and two papers using discrete choice methodology. One by Tracey-Lea Laba evaluated cost sharing for long-acting beta-agonists in Australia, and another by Dean Regier, Verity Watson and Jonathon Sicsic explored choice certainty and choice consistency in DCEs using Kahneman’s dual processing theory.
Having been to three HESG meetings, there are lots of similarities with the format of VanHEM. For instance, papers are discussed for 20 minutes by another attendee, and the author has 5-minutes for clarification. What is different is that before a wider discussion, members of the audience break into small groups for 5 minutes. In my experience, this addition has been very effective at increasing participation during the final 25 minutes of the session, which is an open discussion amongst all attendees. It also gave attendees the opportunity to swap tips on where to find the best deals on plaid shirts.
I was fortunate enough to have my paper accepted and discussed by Prof Larry Lynd from the UBC Faculty of Pharmaceutical Science. Prof Lynd provided a number of excellent suggestions. Of particular note was a much simpler and more intuitive description of the marginal rate of substitution.
VanHEM also afforded an opportunity for discussion and reflection within the local health economics community. Recently, the Canadian Institutes for Health Research launched the Strategy for Patient-Oriented Research (SPOR). In BC, this involves an $80 million investment to “foster evidence-informed health care by bringing innovative approaches to the point of care, so as to ensure greater quality, accountability, and access of care”. One innovative approach is the creation of a new health economics methods cluster in the province, which is co-led by David Whitehurst (Simon Fraser University) and Nick Bansback (University of British Columbia). It receives SPOR funds to help support the health economics community as a whole, and specific research projects that focus on novel methods. At VanHEM, one hour was dedicated to determining how the cluster could help support the community that sees many health economists located at different sites throughout the region. Participants suggested having a number of dedicated academic half-days throughout the year that aim to provide an opportunity for members of the community to see each other face-to-face and engage in activities that support professional development. The theme of great titles continued with the suggestion of a “HEck-a-thon”.
Overall, this year’s VanHEM meeting was a great success. The addition of a pre-meeting workshop provided an excellent opportunity for our community to gain practical experience in causal methods, and we continue to see increased numbers of participants from outside our local region. I’m looking forward to doing this again in 2018, and I would encourage anyone visiting our region to be in touch!