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Health Economics and Economic Evaluation

Health economics may be defined as a sub-discipline of economics and involves the application of theories and methods of economics on the topics health and health care. This research-group is doing research within health economics with a focus on health economic evaluation.

Health economic evaluation may be defined as ”the comparative analysis of alternative courses of action in terms of both their costs and consequences” and is used to provide guidance for decisions aiming at improving the efficiency of the allocation of resources to improve health.

Research is also performed in behavioral economics, a research area based in economics and psychology. Behavioral economics studies economic decision making in experiments in order to improve the explanatory and predictive power of economic models. Ongoing projects are multidisciplinary in economics, health and medicine.

Education is a significant part of the activities of the research group, where the Master's Programme in Health Economics, Policy and Management plays a major role.

Research projects

Health Economic Evaluation


The aim of the projects is to evaluate the effectiveness and costs of the combination of spinal manipulation and exercise for treating non-specific chronic low back pain as compared to spinal manipulation, exercise and information/advice.


A program to develop and implement a new social care pathway for patients with orphan diseases. The program is coordinated by the Ministry of Health in Spain and involves eight partners across Europe. KI is responsible for the economic evaluation of the new pathway.

Behavioral Economics


In a research project in collaboration with the Women´s Health Research Unit, Karolinska University Hospital (Solna), and the Stockholm School of Economics we explore the effects of oral contraceptives on women’s health-related quality of life, and behavior using a double-blind study design. 340 participants fill out questionnaires on health related quality of life at baseline and after 3 months of treatment. After treatment they also take part in an economic experiment on decision-making, including tests of altruism, financial risk taking and willingness to compete. Additionally we will also study menstrual cycle effects on health related quality of life and behavior.


Master's Programme in Health Economics, Policy and Management

The Master's Programme in Health Economics, Policy and Management consists of two years’ full time studies in the second cycle (Master’s level), amounting to 120 credits. The programme provides an opportunity for students to develop theoretical and practical skills for analysing health and healthcare issues from an organisational and a policy perspective. Health economics focuses on the financing of health care, the methods for economic evaluation of health care technologies and on the measurement and valuation of health. Policy contains planning for health and methods for the development, implementation and analysis of policy in the health care system while management focuses on methods for health and medical care management. More information.

Selected publications

Hormonal Contraceptives Do Not Impact Economic Preferences: Evidence from a Randomized Trial
Ranehill E, Zethraeus N, Blomberg L, von Schoultz B, Lindén Hirschberg A, Johansson M, Dreber A.
2017 Oct; Management Science;

A first-choice combined oral contraceptive influences general well-being in healthy women: a double-blind, randomized, placebo-controlled trial.
Zethraeus N, Dreber A, Ranehill E, Blomberg L, Labrie F, von Schoultz B, Johannesson M, Hirschberg AL.
Fertil Steril. 2017 May;107(5):1238-1245.

Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial.
Zethraeus N, Dreber A, Ranehill E, Blomberg L, Labrie F, von Schoultz B, et al
J. Clin. Endocrinol. Metab. 2016 Nov;101(11):4046-4053

Metabolic effects and cost-effectiveness of aripiprazole versus olanzapine in schizophrenia and bipolar disorder.
Kasteng F, Eriksson J, Sennfält K, Lindgren P
Acta Psychiatr Scand 2011 Sep;124(3):214-25

A randomized trial of the effect of testosterone and estrogen on verbal fluency, verbal memory, and spatial ability in healthy postmenopausal women.
Kocoska-Maras L, Zethraeus N, Rådestad AF, Ellingsen T, von Schoultz B, Johannesson M, et al
Fertil. Steril. 2011 Jan;95(1):152-7

A randomized trial of the effect of estrogen and testosterone on economic behavior.
Zethraeus N, Kocoska-Maras L, Ellingsen T, von Schoultz B, Hirschberg AL, Johannesson M
Proc. Natl. Acad. Sci. U.S.A. 2009 Apr;106(16):6535-8

Economic evaluation of ASCOT-BPLA: antihypertensive treatment with an amlodipine-based regimen is cost effective compared with an atenolol-based regimen.
Lindgren P, Buxton M, Kahan T, Poulter NR, Dahlöf B, Sever PS, et al
Heart 2008 Feb;94(2):e4

Cost-effectiveness of high-dose atorvastatin compared with regular dose simvastatin.
Lindgren P, Graff J, Olsson AG, Pedersen TJ, Jönsson B,
Eur. Heart J. 2007 Jun;28(12):1448-53

Definition, interpretation and calculation of cost-effectiveness acceptability curves.
Löthgren M, Zethraeus N
Health Econ 2000 Oct;9(7):623-30


Zethraeus N. Health Technology Assessment (HTA) och ekonomisk utvärdering vid utvärdering av hälso- och sjukvårdens metoder. Stockholm: Karolinska Institutets folkhälsoakademi, 2009. Rapport 2009:19.

Johannesson M, Jönsson B, Jönsson L, Kobelt G, Zethraeus N. Why Should Economic Evaluations of Medical Innovations Have a Societal Perspective? OHE Briefing No 51, 2009.

Lindgren, P., Ersättning i sjukvården. Modeller, effekter och rekommendationer. 2014, Stockholm: SNS Förlag.

Research in the media

A study, published in Fertility and Sterility, conducted by researchers at Karolinska Institutet in Sweden in collaboration with the Stockholm School of Economics shows that one of the most common combined oral contraceptive pills has a negative impact on women’s quality of life. Read more about the study Oral contraceptives reduce general well-being in healthy women.

In a previous study, published in the Journal of Clinical Endocrinology & Metabolism in 2016, Niklas Zethraeus and co-authors show that oral contraceptives have no negative impact on overall sexual function, although three (desire, arousal, and pleasure) of seven sexual function domains were adversely affected.

Research group