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£/QALY Health Economics Metrics
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  • United Kingdom Government Digital Service
  • United Kingdom National Health Service England For Patients
  • United Kingdom National Health Service England For Practitioners
  • United Kingdom National Health Service Scotland For Patients
  • United Kingdom National Health Service Scotland For Practitioners
  • United Kingdom National Health Service Wales For Patients
  • United Kingdom National Health Service Wales For Practitioners
  • United States Web Design System
Economic reasoning foundations
  • Opportunity cost
  • Discounting and time preference
  • Analysis perspective
  • Time horizon
  • Marginal vs average cost
  • Cash-releasing vs non-cash-releasing savings
  • Sensitivity analysis
  • Probabilistic sensitivity analysis
  • Expected value of perfect information
  • Dominance and the efficiency frontier
Outcome measures
  • Quality-adjusted life year (QALY)
  • Disability-adjusted life year (DALY)
  • EQ-5D
  • Incremental cost-effectiveness ratio (ICER)
  • Willingness-to-pay thresholds
  • Net monetary benefit (NMB)
  • Life-years gained
  • Health-adjusted life expectancy (HALE)
  • QALY shortfall and severity modifiers
Economic analysis types
  • Cost-effectiveness analysis (CEA)
  • Cost-utility analysis (CUA)
  • Cost-benefit analysis (CBA)
  • Cost-minimization analysis (CMA)
  • Cost-consequence analysis (CCA)
  • Budget impact analysis (BIA)
  • Return on investment (ROI)
  • Social return on investment (SROI)
Health system operational economics
  • Bed days saved
  • Length of stay
  • Readmission rate
  • Did-not-attend (DNA) rate
  • Emergency attendance avoidance
  • National tariff and unit costs
  • Referral to treatment (RTT)
  • Waiting list impact
  • Practitioner time
  • Workforce retention
  • Avoidable outsourcing costs
  • Downstream resource optimization
  • Earlier intervention
  • Value-generating capacity (operational turnaround)
  • Hard cash-releasing savings (deficit defense)
HTA frameworks and prevention economics
  • Health technology assessment (HTA)
  • NICE Evidence Standards Framework
  • Germany's DiGA fast-track
  • Number needed to treat (NNT)
  • Prevention economics
  • Screening economics
  • Avoided downstream costs
Software engineering and digital delivery
  • Cost of delay
  • DORA metrics
  • Flow metrics
  • WSJF and CD3
  • SPACE and DevEx
  • Technical debt
  • Total cost of ownership (TCO)
  • Cloud unit economics (FinOps)
  • Build vs buy
  • Benefits realization
  • GDS service metrics
AI acceleration
  • AI developer productivity
  • AI return on investment
  • Inference unit economics
  • AI quality metrics
  • Clinical AI evaluation
  • AI regulatory evaluation
Consumer health apps and devices
  • Engagement metrics
  • Retention and churn
  • Activation and uptake
  • Adherence and persistence
  • Patient-reported outcomes
  • Digital endpoints and biomarkers
  • Wearable validation
  • Remote patient monitoring economics
  • Health app unit economics
  • Reach and equity

Contents

All 76 topics in reading order, across 8 parts. Each topic covers one metric or concept: definition, why it matters, the math, a worked example, the software engineering connection, pitfalls, and sources.

Economic reasoning foundations

10 topics

  1. Opportunity cost the value of the best alternative forgone; why fixed budgets make every choice a displacement
  2. Discounting and time preference present values, the 3.5% Green Book/NICE rate
  3. Analysis perspective payer vs provider vs societal: whose costs count
  4. Time horizon how long to count costs and effects, and horizon gaming
  5. Marginal vs average cost why freeing a bed doesn't save its average cost
  6. Cash-releasing vs non-cash-releasing savings the honesty test for every "time saved" claim
  7. Sensitivity analysis tornado diagrams; which assumption carries your case
  8. Probabilistic sensitivity analysis Monte Carlo, CEACs, probability of being right
  9. Expected value of perfect information pricing the pilot before you run it
  10. Dominance and the efficiency frontier eliminating options nobody should pick

Outcome measures

9 topics

  1. Quality-adjusted life year (QALY) the common currency of health value
  2. Disability-adjusted life year (DALY) the burden-side mirror; global health's metric
  3. EQ-5D the instrument behind most QALY utility weights
  4. Incremental cost-effectiveness ratio (ICER) extra cost per extra unit of health
  5. Willingness-to-pay thresholds NICE £20–30k/QALY and the world's other lines
  6. Net monetary benefit (NMB) value minus cost, done properly
  7. Life-years gained survival math, and the evLYG equity variant
  8. Health-adjusted life expectancy (HALE) population-level healthy-years accounting
  9. QALY shortfall and severity modifiers why sicker populations' QALYs count more

Economic analysis types

8 topics

  1. Cost-effectiveness analysis (CEA) cost per natural unit of outcome
  2. Cost-utility analysis (CUA) cost per QALY; comparing unlike interventions
  3. Cost-benefit analysis (CBA) everything in money; Green Book NPV
  4. Cost-minimization analysis (CMA) cheapest option, after proving equivalence
  5. Cost-consequence analysis (CCA) the disaggregated table; NICE's preference for digital health
  6. Budget impact analysis (BIA) affordability, as distinct from value
  7. Return on investment (ROI) the shared metric, with declared parameters
  8. Social return on investment (SROI) monetizing what markets don't price

Health system operational economics

15 topics

  1. Bed days saved the workhorse benefit, and its valuation traps
  2. Length of stay the hospital's cycle time
  3. Readmission rate the health system's change failure rate
  4. Did-not-attend (DNA) rate missed appointments; the purest waste metric
  5. Emergency attendance avoidance upstream intervention economics
  6. National tariff and unit costs the NHS price book and costing infrastructure
  7. Referral to treatment (RTT) the 18-week standard as a lead-time metric
  8. Waiting list impact converting saved hours into patients seen
  9. Practitioner time valuing bottleneck capacity, not wages
  10. Workforce retention turnover costs and burnout economics
  11. Avoidable outsourcing costs repatriating premium-rate work
  12. Downstream resource optimization unblocking the role everyone waits on
  13. Earlier intervention the economics of treating before progression
  14. Value-generating capacity (operational turnaround) minting capacity without hiring
  15. Hard cash-releasing savings (deficit defense) deleting budget lines; the CFO's metric

HTA frameworks and prevention economics

7 topics

  1. Health technology assessment (HTA) NICE, ICER (US), CADTH: who decides what's worth buying
  2. NICE Evidence Standards Framework risk-tiered evidence requirements for digital health
  3. Germany's DiGA fast-track apps on prescription; provisional listing with an evidence deadline
  4. Number needed to treat (NNT) effort-per-benefit units that keep claims honest
  5. Prevention economics why prevention is cost-effective but rarely cost-saving
  6. Screening economics Wilson–Jungner, PPV collapse at low prevalence, alert fatigue
  7. Avoided downstream costs cost offsets and the rules that make them credible

Software engineering and digital delivery

11 topics

  1. Cost of delay £/week or QALYs/week of non-delivery; the master bridge metric
  2. DORA metrics delivery performance, translated into health-economics terms
  3. Flow metrics Little's Law, WIP, flow efficiency; the shared queueing math of hospitals and pipelines
  4. WSJF and CD3 value-density prioritization; the backlog as a QALY league table
  5. SPACE and DevEx multi-dimensional productivity; the EQ-5D lesson for engineering metrics
  6. Technical debt principal, interest, and chronic-disease economics for codebases
  7. Total cost of ownership (TCO) maintenance is 50–80%; the naive-drug-price error in software
  8. Cloud unit economics (FinOps) cost per unit of output; the digital service's reference cost
  9. Build vs buy risk-adjusted comparison with the delay term priced
  10. Benefits realization auditing that forecast benefits actually happened
  11. GDS service metrics cost per transaction, satisfaction, completion, take-up

AI acceleration

6 topics

  1. AI developer productivity Copilot RCT vs METR RCT; efficacy vs effectiveness
  2. AI return on investment the 95%-no-return finding and what the 5% did differently
  3. Inference unit economics cost per token, and modeling relentless price decline
  4. AI quality metrics hallucination rates as harm rates with a price
  5. Clinical AI evaluation sensitivity, specificity, AUROC, and why prevalence rules the economics
  6. AI regulatory evaluation FDA SaMD, PCCPs, and the economics of model updates

Consumer health apps and devices

10 topics

  1. Engagement metrics engagement as clinical dose
  2. Retention and churn the law of attrition; retention curves as treatment windows
  3. Activation and uptake the front gates of the value funnel
  4. Adherence and persistence MPR, PDC, effective engagement, minimum effective dose
  5. Patient-reported outcomes PROMs, PREMs, and the MCID honesty bar
  6. Digital endpoints and biomarkers from sensor telemetry to regulator-grade evidence
  7. Wearable validation MAPE, agreement statistics, wear-time, completeness
  8. Remote patient monitoring economics CPT code stacks and hospital-at-home substitution
  9. Health app unit economics CAC, LTV, PMPM, and ROI vs VOI
  10. Reach and equity RE-AIM; population impact = reach × effectiveness

Health Economics Metrics — health economics math, examples, and reasoning for software engineers building for national health services.

Figures in this book date quickly. Each topic dates its benchmarks in-line; re-verify before using any number in a live business case.

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