Garau, M., Towse, A., Garrison, L., Housman, L. and Ossa, D.
Diagnostics not only facilitate health gain and cost savings, but also provide information to inform patients’ decisions on interventions and to clarify how their behaviour may affect their health. Current pricing and reimbursement systems for diagnostics, however, are not efficient and provide poor incentives for new diagnostic approaches. Prices often are driven by administrative practice and expected production cost, rather than assessments of value.
In April 2006, payment thresholds were raised for GPs who participate in Scotland’s Ouality and Outcomes Framework. GPs were required to meet new, higher thresholds on some indicators to receive maximum levels of payment. In this paper, OHE’s Yan Feng and her colleagues examine whether this change in fact improved GP performance and whether the impact differed across GPs. Specifically, they examine whether low-, mid- and high-performing GPs changed behaviour and, if so, to what extent.
The NHS Patient Reported Outcome Measures (PROMs) programme, introduced in April 2009, is a significant development in the routine collection and use of patient reported outcome data. Data currently are collected for patients both before and after surgery for four elective surgical procedures in the NHS, with plans to expand the practice.
In 2009, the UK’s National Institute for Health and Clinical Excellence (NICE) issued supplementary advice that its Appraisal Committees are to consider when assessing treatments that extend life at the end of life. This includes an option for approving such treatments for use in the NHS if certain criteria are met, even if base case cost-effectiveness estimates exceed the range usually considered acceptable.
This paper investigates how the increased rate of Quality and Outcomes Framework (QOF) payments implemented on 1 April 2005 affects Scottish general practitioners’ (GPs) intrinsic, extrinsic and overall motivation. A first difference method is used to model GPs’ intrinsic and overall motivation. The main finding is that the increased QOF payment effectively motivated GPs' health care supply, but it also 'crowded out' GPs' intrinsic motivation.
Recent reforms to the National Health Service (NHS) in England include important changes in the regulation of prices for new medicines. From January 2014, the existing Pharmaceutical Pricing Regulation Scheme (PPRS) will be replaced by “value based pricing” (VBP) for branded medicines sold to the NHS. This will apply only to new medicines; those marketed before 2014 will continue to be governed by the PPRS.
Shah, K., Sussex, J., Hernandez-Villafuerte, K. and Garau, M., Rotolo, D., Hopkins, M.M., Grassano, N., Crane, P., Lang, F., Hutton, J., Pateman, C., Mawer, A., Farrell, C. and Sharp, T.
As earlier OHE research has demonstrated, sources of funding for medical research—public, charity and private sector—are complementary, not duplicative. The three sectors also differ in their approaches. As a result, decreased funding from one would not only reduce the overall financing available, but also change the nature of the research effort overall. This is a concern given that austerity in government spending in the UK is likely to continue for some time. This report produced by OHE and SPRU at the University of Sussex for Cancer Research UK explores two sets of questions: 1.
Shah, K., Praet, C., Devlin, N., Sussex, J., Appleby, J. and Parkin, D.
The appraisal of health care technologies by the UK’s National Institute for Health and Clinical Excellent (NICE) focuses on cost effectiveness, usually measured in terms of incremental cost per quality adjusted life year (QALY) gained. According to the findings presented in this Research Paper, however, cost effectiveness does not appear to be the dominant consideration in NHS decisions about resource allocation.
Antimicrobial resistance (AMR) is becoming a major global public health threat and has begun to command attention from European and US policy makers. An initial focus on monitoring AMR and conserving existing treatments by cutting down on misuse has been complemented by moves towards addressing the paucity of new drugs in the R&D pipeline of the pharmaceutical industry.
The UK’s National Clinical Assessment Agency (NCAS) is designed specifically to provide advice on performance issues, on request, to NHS organisations employing or contracting with doctors, pharmacists, and dentists. Currently, the NCAS is financed from central NHS funds, not from charges to NHS organisations. By 2013, however, the NCAS is to become self-funding.