Periodic budget impact

Signature

BI_t = E_A_t - E_R_t

Inputs
Inputs	Definition	Unit
`E_A_t`	Total expenditure expected during period t when the intervention is adopted	currency per budget period
`E_R_t`	Total expenditure expected during period t without adoption	the same currency and budget period as E_A_t

Output
`BI_t`	Change in expenditure during period t attributable to adoption	currency per budget period

Maps reference- and adoption-scenario expenditure to periodic and cumulative changes in spending for a specified budget holder.

E_A_tE_R_t

Comparable scenarios
Reference and adoption scenarios cover the same budget holder population and reporting period.
Adoption-driven differences
The scenarios differ only where adoption is expected to change population flows, treatment mix, resource use, prices or implementation.
Consistent monetary basis
Both scenarios use the same currency, price year and nominal-or-real convention.
Budget-relevant expenditure
Costs and savings are included only when they affect the stated budget holder during the specified period.

Year-one expenditure increase
Reference-scenario expenditure is £21,000,000 and adoption-scenario expenditure is £21,900,000. The year-one budget impact is a £900,000 expenditure increase.
```
t = 1; E_A_t = 21900000; E_R_t = 21000000; BI_t = 900000
```

Using unchanged current practice as the reference automatically
The reference scenario should represent the expected future without adoption and may include changes in population, treatment patterns, prices and clinical practice.

ISPOR budget impact good-practice report
Sullivan SD, Mauskopf JA, Augustovski F, Jaime Caro J, Lee KM, Minchin M, et al. Budget impact analysis: principles of good practice. Report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. Value in Health. 2014;17(1):5-14.
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