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Chunyu Li, PhD, MD Health Economist

Importance of Economic Work. . Resources are limitedRigorous economic analyses are required to: Evaluate the effectiveness, costs, and cost-effectiveness of the ProgramMonitor the allocation of Program resources to balance efficiency and equitySystematically provide information/evidence

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Chunyu Li, PhD, MD Health Economist

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    1. Chunyu Li, PhD, MD Health Economist Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention and Control

    2. Importance of Economic Work

    3. Introduction of National Cancer Screening Programs at CDC

    4. Introduction of National Cancer Screening Programs at CDC (Cont.) NPCR (1992-present) National Program of Cancer Registries Collects data on the occurrence of cancer; the type, extent, and location of the cancer; and the type of initial treatment. NCCCP (1998-present) National Comprehensive Cancer Control Programs Provides seed money and technical support for the development and implementation of CCC plans.

    5. Economists in DCPC Donatus U. Ekwueme, PhD, MPH Leading economic evaluation of NBCCEDP and NCCCP Florence K. Tangka, PhD, MPH Leading economic evaluation of NCRCCP and NPCR Chunyu Li, PhD, MD Program evaluation, Comparative-Effectiveness analysis, cost of illness, policy analysis

    6. Selected Economics Project (I) Program-specific research Cost estimation Direct Indirect Effectiveness evaluation Policy analysis General economics research Cost of illness Comparative-Effectiveness analysis Health care access and use Trends

    7. Brief History of NBCCEDP Economics Study This project was originally funded in FY04 (Led by Dr. Ekwueme) It was the first comprehensive economic analysis in the Division that set the stage for all subsequent economic analyses being conducted in our national programs today

    9. Selected Economics Project (II) Program-specific research Cost estimation Direct cost Estimate the unit costs of delivering clinical and non-clinical services in the program (e.g., cost per woman screened or served, cost per cancer detected) (Ekwueme et al., 2008; Tangka et al., 2008) How much funding is required annually by each program? What funding sources are used by each program (i.e., CDC, state funds, in-kind funds)? What is the distribution of costs among the key program components for each program? What is the average and incremental non-clinical cost per person screened for each program? Does average and incremental cost change across the years for each program?

    10. Data Collection Methods for Cost Estimation Web-based data collection tool Cost Assessment Tool (CAT) Program’s cost methods are based on the activity-based costing approach Cost data is collected by program activity, which provides an accurate reflection of the value of resources (economic cost) utilized in providing services via the program Example Activities:

    14. Cost Assessment Tool (CAT)

    15. 2) Total Expenditure

    16. Estimated Average Total Cost for Women Served, Selected Programs, 2003–2004

    17. Estimated Distribution of Median Cost per Woman Served by Program Component, 2003–2004*

    19. Selected Economics Project (III) Program-specific research Cost estimation Indirect cost NBCCEDP & NCRCCP survey among Program participants (Ekwueme et al., 2008) Resource Allocation Tool (RAT) Given a specific budget, the RAT can identify the most efficient way to allocate the funding among the grantees To determine the minimum and maximum number of NBCCEDP-eligible women that can be screened given the available resources (e.g., program budget) To determine the amount of resources required to screen 25%, 50%, 75%, or 100% of eligible women

    20. Selected Economics Project (IV) Program-specific research Effectiveness evaluation % of eligible population screened (Tangka et al., 2006, 2010) 14% for breast cancer 10% for cervical cancer Life years saved by NBCCEDP compared with no program (Ekwueme et al., 2010) Policy analysis Impact evaluation of National programs (Howard et al., 2010; NCRCCP surveys) Potential impact of Health Reform on NBCCEDP

    21. Future Economics Project Program-specific research Cost estimation Effectiveness evaluation (e.g. eliminating health disparities) Comparative-Effectiveness evaluation Returns of investment Other National policy initiatives

    22. Acknowledgement DCPC colleagues RTI

    23. National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention and Control

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