Health Economics and Economic Evaluation – Niklas Zethraeus' group

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.

Blocks with icons representing health and healthcare stacked on top of each other like a pyramid.

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 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.

What we do

Previous research

The research group conducts health economic studies to improve the basis for health care decision making on how to use limited health care resources to improve health. Different health care technologies have been assessed with respect to health outcomes and costs, for instance hormone replacement therapyspinal cord stimulationphysiotherapy, and chiropractic care.

In behavioural health economics we have studied the causal relationship between hormones and economic behaviour and health. Studies indicate that birth control pills do not impact economic behaviour and may negatively impact well-being and some dimensions of sexual function, and that sex hormones do not impact economic behaviour outcomes (PNAS 2009J Clin Endocrinol Metab 2016Fertility & Sterility 2017Management Science 2018).

Ongoing and planned research

The following research projects are currently being conducted:

  • Health economic aspects of pancreatic cancer

The aim is to increase the understanding of the societal impact of pancreatic cancer. Based on comprehensive Swedish registry data, we investigate the loss in life expectancy following pancreatic cancer, and whether society should invest in AI applications for earlier identification of pancreatic cancer. Further, in an EU-project, we study the budget impact and how to prioritize among potential early detection strategies for pancreatic cancer in Sweden and Germany.

  • How to improve health economic evaluations for decision making

In a recent study, we investigated the accuracy of survival predictions in cost-effectiveness analyses conducted by the Dental and Pharmaceutical Benefits Agency (TLV) to decide on the reimbursement and use of oncology drugs in Sweden (Björnerstedt et al 2024). As part of a FORTE project, we plan to further validate and improve survival predictions in cost-effectiveness analyses to guide the reimbursement and use of oncology drugs in Sweden.

  • Impact of parental imprinting on economic preferences

Following a pre-published analysis protocol, the aim of this ongoing study is to explore the potential impact of parental imprinting on economic preferences (altruism, financial risk taking, and willingness to compete) and other outcomes in women with Turner’s syndrome. 

Licentiate and doctoral degree projects

  • Emma Söreskog, Spinal cord stimulation in chronic pain: A study of health outcomes and costs, KI, 2021
  • Olivia Ernstsson, “Making use of patient-reported outcome measures in health care: the case of EQ-5D in the Swedish national quality registries”, KI, 2021
  • Filip Gedin, “The burden of back pain: evaluation of costs and health outcomes”, KI, 2020
  • Oskar Ström, “Pharmacoepidemiology and health economics of adherence to pharmaceutical fracture prevention”, KI, 2020

Communication of results

  • Press-release, KI (2022): “People with long-term neuropathic pain took significantly fewer sick days from work after treatment with spinal cord stimulation”, published in PAIN.
  • Press-release, KI (2021) “Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change?”, published in BMJ Open
  • Press-release, KI (2017) “Oral contraceptives reduce general well-being in healthy women”, published in Fertility and Sterility

 

Research collaborations

Our research collaborations include expertise in medicine, biostatistics, and register-based research, and we collaborate with research groups at KI (Department of Medical Epidemiology and Biostatistics - MEB, and Department of Clinical Science, Intervention and Technology – CLINTEC), Stockholm School of Economics, Uppsala University, governmental agencies (TLV), and Center for Health Economics, Informatics and Healthcare Research (CHIS) at Region Stockholm. We have developed extensive international collaborations with the University of Hamburg and University Medical Center Hamburg-Eppendorf (UKE) in Germany, and we are also part of a collaboration with Department of Neurobiology, Care Sciences and Society – NVS (KI), and Precision Medicine Center Karolinska – PMCK (Karolinska University Hospital – KS and KI), aimed at contributing increased knowledge about health economic aspects and the societal value of precision medicine.

Publications

Selected publications

Education

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.

Keywords:
Epidemiology Health Care Economics and Organizations Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health and Social Medicine
Content reviewer:
04-04-2025