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 EPI 213

Cost-Effectiveness Analysis
in Medicine and Public Health
EPI 213 Winter 2018 (2 units)


In a world where policy-makers, donors, and payers are increasingly cost-sensitive, how does one measure returns on investments in health? Cost-effectiveness analyses can help formally evaluate clinical and policy decisions, particularly when decisions have to be made on the basis of incomplete or imperfect information (as is usually the case). The objectives of this course are to give students an understanding of:

  • The use of decision trees to portray alternative courses of action and their consequences;
  • Principles of cost-effectiveness analysis, including estimating costs and health outcomes, and estimating metrics of cost-effectiveness;
  • Uncertainty in input parameters, and how this translates into uncertainty in the principal result of cost-effectiveness analyses;
  • Sensitivity analyses, and their central role in informing decisions in the setting of imperfect information;
  • Markov modeling to understand long-term costs and consequences of clinical and policy decisions;
  • Effective verbal and written communication of cost-effectiveness analyses;
  • Real-world examples of cost-effectiveness analyses that influenced clinical guidelines or health policy;
  • Specific challenges with cost-effectiveness analyses pertaining to low- and middle-income countries; and
  • Critical review of published cost-effectiveness analyses.

Designing Clinical Research (EPI 202) and working familiarity with MS Excel, including navigation through a workbook and basic entry/copy/paste functions, and willingness to learn graphing and other functions.


Course Director:

Dhruv Kazi, MD, MSc, MS
email: kazi@ucsf.edu


James Kahn, MD, MPH
email: jgkahn@ucsf.edu

Elliot Marseille, DrPH, MPP
email: emarseille@comcast.net

Teaching Assistants:

Aida Venado, MD
email: aida.venado@ucsf.edu


There will be 6 core sessions on methods and 6 sessions focused on review of homework assignments and discussion of questions from lecture or syllabus. These sessions will occur on Thursdays from 1:00 PM to 3:00 PM, Jan. 11 to Mar. 22.

Students are required to participate in a group project of their choice, beginning early in the course, and present their findings at the end of the course. Projects may require 4-5 hours of work outside of class time every week and are critical to hands-on learning of course material. They also offer an opportunity for future research publications.

The course also incorporates a one-day seminar (typically on a Friday in February) that brings together international experts, policy-makers, and trainees to explore contemporary issues in global health economics. Attendance is strongly encouraged.

All course materials and recorded lectures will be posted on the course's online syllabus.


The following textbooks are recommended but not required.

Methods for the Economic Evaluation of Health Care Programmes by M. F. Drummond et al. Oxford Medical Publications. 4th Edition. 2015.

Decision Modeling for Health Economic Evaluation by A. Briggs, M. Sculpher, and K. Claxton. Oxford University Press. First edition. 2006.

Books may be purchased either through the publisher or a variety of commercial venues (e.g., Amazon.com).

The course will be taught using TreeAge Pro software. A trial version to evaluate the software is available online. (Note that the trial version expires in 30 days; it may help to delay starting the trial till week 2 of the course). UCSF enrollees can access the software through MyResearch (you may have to request an account in advance). Other options include obtaining a student course license ($45, 6 months with limited options) and a student research license ($250, 1 year). Students will need one license per group project. Students who are proficient in MS Excel are welcome to build the model in that platform.


Grades will be based on total points achieved in three categories:

  1. Group project: 40% (inputs, analysis, class presentation). There must be clear delineation of individual roles students played during the project.
  2. Project summary: 30% (600 word “research letter” format, presenting findings including 1 table and 1 figure). To be written individually and not shared among team members.
  3. Class participation or mid-term: 30%.

Students not in full-year TICR Programs who satisfactorily pass all course requirements will, upon request, receive a Certificate of Course Completion.

UCSF Graduate Division Policy on Disabilities


This course is open to a limited number of individuals outside of the ATCR and Master's programs. Preference is given to UCSF-affiliated personnel. We regret that auditing is not permitted.

To apply for this course, please fill out and submit the application below. Please see our fees page for cost information. The deadline for application is December 22, 2017. Only one application needs to be completed for all courses desired during the quarter.

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