Determining and defining value in health care is a persistent challenge in every country. To some extent, what constitutes value depends on perspective, e.g. a pharmaceutical company may view value somewhat differently than a doctor or a hospital administrator.
The issue of rising prescription drug prices is a concern in every country. Dozens of policy initiatives and hundreds of research projects over last the fifty years have attempted to find solutions to pricing that provide an appropriate balance between the cost to health care systems and incentives for R&D. To name but a few, these include reference pricing, managed entry agreements, price-volume agreements, rebates, and risk sharing. The ultimate solution, however, remains elusive.
Personalised medicine, also known as ‘precision’ or ‘stratified’ medicine, targets treatment by using genetics and/or biomarkers to identify patients or subgroups of patients who have distinct mechanisms of disease or who may respond to treatment in a particular way. The goal is to provide more effective care, which potentially not only benefits the patient but also improves the efficiency of the healthcare system.
The World Health Organisation (WHO) has become quite skilled at promoting what changes are desirable in health care systems, and why, but has largely left how to implement those changes to individual countries. Although certainly no one solution will fit all countries, some evidence-informed guidelines and insights about how to implement change successfully may help ensure progress in large-scale health system transformation.
Gonzalez-Esuerra, J., Karlsberg, S. and Paling, S.
The NHS Improvement Economics team is part of the Strategy Directorate in NHS Improvement. NHS Improvement aims to implement changes to help improve both quality and efficiency. Recent research by the Economics team intended to support this has included research on A&E performance, NHS staffing, and inpatient falls.
Health System Strengthening (HSS) is an important concept now widely discussed, but too often without sufficient structure or an adequate understanding of what actually is involved. The articles on which this seminar is based (Morton, Thomas and Smith, 2016; Smith and Yip, 2016) attempted to present more clearly just what health system strengthening might entail and whether that might be modelled.
Gene therapies, which can provide cures for diseases, are a new area of research for ICER. Some are within two to three years of becoming available publicly. This is exciting, but also offers serious and critical challenges in valuation. The focus of this seminar briefing is on those challenges.
This OHE publication by Nick Timmins, a senior fellow at the Institute for Government and the Kings Fund, sets out arguments in favour and against. It is based on the seminar he gave at OHE in July 2018.
This seminar briefing examines (1) why the UK has not produced large biotech firms that develop drugs, similar to those in the United States (US), (2) why the UK biotech firms that do exist have not brought blockbuster drugs to the market and (3) what the implications are for industrial strategy after Brexit. These remarks are based primarily on research we completed for our recent book, Science, the State and the City (Owen and Hopkins, 2016), with some additions and specific observations about the potential effects of Brexit.
This seminar focuses on the NHS staffing markets and the use of temporary staff, specifically in the NHS provider sector, i.e. foundation trusts and NHS trust. (which include hospitals). To provide background and context, the discussion begins with an overview of the NHS labour market and the role of staffing agencies in providing temporary staff. The core of the seminar is an examination of previous strong growth in expenditure on such staffing, particularly during the early part of this decade; the effects to date of government intervention to address that spending; and possible lessons for other sectors from the limited evidence now available.