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.
Devlin, N., Buckingham, K., Shah, K., Tsuchiya, A., Tilling, C., Wilkinson, G. and van Hout, B.
OHE was awarded a UK Department of Health grant to further develop three aspects of health status indexes. Results of the second of these, advances in Time Trade Off (TTO) methodology, are reported in this OHE Research Paper.
Garau, M., Shah, K., Mason, A.R., Wang, Q., Towse, A. and Drummond, M.F.
Current methods for constructing quality adjusted life year (QALY) measurements may be deficient for cancer patients in three respects: descriptions of health state, valuation of health state, and the source of values upon which measures are based.
Existing measures of health are either not sensitive enough or not attuned to cancer patients’ actual preferences. For example, evidence suggests that the EQ 5D instrument does not capture the small changes in health that often are very important to cancer patients.