This year, the OHE team published 39 peer reviewed journal articles, gave 58 lectures and conference presentations, posted 22 in-house OHE publications on our website, and hosted 6 lunchtime seminars and our annual lecture.
2018 was OHE’s second full year as a not-for-profit group. During the year, OHE’s team of 20 people authored 39 published peer reviewed journal articles and gave 58 lectures and conference presentations. We posted 22 in-house OHE publications on our website, hosted 6 lunchtime seminars and our annual lecture, and our work has been widely cited by decision makers, as well as both the national and specialist trade media.
This year, we have reorganised into four research themes.
Judging value for money and improving decision making
This has included participation in (i) the ISPOR Special Task Force on US Value Assessment Frameworks, leading to OHE co-authorship of three external publications and (ii) co-leading the Value in Health Affordability in Healthcare themed issue with two OHE authored external publications.
The biggest and most controversial area is the estimation and use of measures of opportunity cost in the NHS. We are in the final stages (publishing in early 2019) of preparing the results of a research project funded by the ABPI looking at opportunity cost across English NHS disease areas (programme budget categories) and across commissioners. The project explores three new approaches to improve understanding of supply side opportunity costs for the English NHS. We set out our approach earlier in the year.
Economics of innovation
OHE undertook two research projects on new reimbursement models.
One, funded by IQVIA, considered innovative payment models including multi-indication pricing as an alternative to single prices. Collaborators included Richard Sullivan (King’s College London). The key finding is that these models can lead to more competition and so better value for money for payers.
The other, funded by Cancer Research UK, entitled making outcomes-based payments a reality in the NHS, considered the potential for outcomes-based reimbursement in cancer focussing on the Manchester health area. This is a collaboration with RAND Europe and King’s College London to be published in early 2019.
Research work with the US Institute of Comparative Effectiveness Research (ICER) Summits in 2017 led to two publications in 2018 on good practice in the use of real world evidence by payers. We have also released a Consulting Report with funding from EFPIA to address good governance arrangements to improve R&D efficiency. Earlier in the year, we published a Research Paper on the impact of competition in the provision of treatments for hepatitis C in five European countries, with a research grant from Gilead.
During 2018, together with the Centre for Global Development, OHE secured research funding from the Bill and Melinda Gates Foundation to consider innovative incentives to tackle TB in middle income countries. The CGD / OHE proposals will be set out in early 2019.
Incentivising quality
For the team working on projects in this research theme, there is a lot of work in progress. We have NIHR-funded research on the effectiveness and value for money of the Prescribed Specialised Services (PSS) Commissioning for Quality and Innovation (CQUIN) schemes, which are run by NHS England. The EuroQol Foundation has funded our research on clinical quality of primary care and patient self-reported outcomes. And there’s more in the pipeline to be announced in 2019.
Measuring and valuing outcomes
The measuring and valuing outcomes theme has been the largest in terms of outputs in 2018, for both research and for consulting clients. We have demonstrable evidence of impact, via the relevance of our work for NICE, DHSC and other health care organisations internationally. We are undertaking outcomes related work in Ireland, India, Mexico, Sweden, Canada, and China.
OHE has established an excellent reputation for doing innovative, ideas-driven research, particularly in relation to valuation and analysis of EQ-5D. OHE had four papers at the EuroQol Plenary meeting in Lisbon. One important project, funded by the EuroQol Research Foundation, is entitled “Drop dead: an assessment of the conceptual basis for ‘death’ as an anchor in health state valuation”. This is typical of the sort of conceptual work that OHE does, with real practical relevance to health state valuation, which should underpin any assessment of treatment benefit.
We will be publishing Peter Smith’s annual lecture early in the new year in which he focussed on how health systems like the NHS should make their case to finance ministries for more money. Instead of appearing to be a bottomless pit, they should produce productivity and efficiency measures that are generally recognised and focus on getting people back to productive activity, in part by focussing more on ability to function, which is not just getting people back to work, but also enabling older people to remain independent for longer periods and indeed to look after their grandchildren. These effects have a real impact on economic performance and on public expenditure.
People
We welcomed to the OHE team OHE’s new Director Graham Cookson, who takes over from Adrian Towse, who becomes Director Emeritus and Senior Research Fellow, as well as Olga Rozanova and Charlotte Davies.
We are sorry to lose OHE’s Deputy Director and Head of Consulting Paula Lorgelly, and Nancy Devlin, OHE’s first Director of Research. An announcement of both OHE’s new Head of Research and new Head of Consulting will be made very soon. We were also sad to lose Yan Feng and David Mott. We wish all of our departing colleagues every success.
