Table of Contents
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In memory of our friend and colleague Bernie OBrien
1959-2004
Tragically Bernie OBrien passed away on 13th February 2004. He was 44 years old. At the time of his death we had already planned this edition and Bernie was looking forward to contributing to the revision, which the rest of us undertook during August 2004, when we were all together at McMaster.
After completing the MSc in Health Economics at the University of York, Bernies career in health economics began in earnest when he became a research fellow in the Health Economics Research Group at Brunel University, London. His first project was the economic evaluation of the heart transplant programme in the UK, working alongside Professor Martin Buxton. Their report was widely acclaimed as one of the best health technology assessments of its time and helped to establish the importance of health economics in the minds of senior decision-makers in the UK.
After eight years, and several other projects at Brunel, Bernie sought new opportunities in Canada. The Department of Clinical Epidemiology and Biostatistics was the perfect place for Bernie to develop his talents, given his commitment to multidisciplinary working and interest in clinical research.
As well as undertaking a number of important empirical studies, Bernie made significant contributions to the development of the methodology of economic evaluation. Two in particular stand out. First, he produced several innovative papers concerning the application of statistical methods in cost-effectiveness studies. Secondly, Bernie had a strong interest in the valuation of health outcomes. He produced a number of conceptual papers on contingent valuation and its relationship with the more widely-used utility approach. He also explored the difference between willingness-to-pay and willingness-to-accept in the context of health care.
When the time came to produce a second edition of Methods for the Economic Evaluation of Health Care Programmes, Bernie was an obvious fourth co-author. Not only was he primarily responsible for two chapters of the book, but he also had a substantial influence on the way in which issues were presented and discussed. This was no mean achievement faced, as he was, with three co-authors who thought they had got it right first time round!
A particular passion for Bernie was the development of young investigators. Therefore he invested considerable time and effort in attracting funding that would enable up-and-coming researchers to spend time working with him in the Centre for Evaluation of Medicines at McMaster. Several of these individuals have now developed into impressive researchers in their own right.
Although Bernies scientific achievements were considerable, the lasting memory for those who worked with him will be his sense of humour. Teaching with Bernie was a joy and the hundreds of individuals who have passed through training programmes at McMaster will remember his skilful use of cartoons and anecdotes. Bernie was always looking for a humorous comment or joke that would help his students understand the concepts he was trying to convey.
Bernie will be greatly missed. He leaves a wife, Karen, and two daughters, Emma and Lucy. Our thoughts go out to them. We will miss a friend who was eternally cheerful and who hardly had a bad word to say about anyone.
Preface to the first edition
We regard this book as a truly joint effort arising from our common concern to improve the quality of economic evaluation in the health care field.
For a number of years we have been independently engaged in teaching, research, and consultancy in this area. In particular we have offered advice to colleagues from other disciplines and on many occasions have been part of multidisciplinary teams undertaking evaluations of programmes or treatments. These experiences have convinced us of the need for a book which discusses the methodological principles of economic evaluation in health care in a way that would benefit those who plan to undertake such studies.
The book has two particular roots. First, the MS737 course (Economic Analysis for the Evaluation of Health Services) in the Faculty of Health Sciences at McMaster University, which we all have instructed at some stage, attempts to provide a basic grounding in economic evaluation methodology. During the course, the students undertake an evaluation of a programme or health care treatment of their choice. The course assessment is based on the completion of the project.
Second, the Seminex Workshop Series, coordinated by the Faculty of Business at McMaster, has provided the impetus for us to polish our course materials and to make them more free-standing.
What you see here is the result of these roots. The material has been tried and tested both in graduate and continuing education settings. We hope that it meets the needs of the wide readership that is envisaged.