Cost-effectiveness analysis (CEA) is the economic evaluation method that is typically preferred by health technology assessment agencies. Quality-adjusted life years (QALYs) – a composite measure of quality and quantity of life – are often used as the measure of benefit in a CEA. The quality of life component requires health state utilities, which are anchored at one (indicating full health) and zero (indicating being dead).
Firth, I., Schirrmacher, H., Hampson, G. and Towse, A.
Early access schemes (EASs) can enable access to medicines prior to completion of the regulatory process. EASs allow national regulators to issue an initial positive assessment of the balance between benefits and risks for groups of patients on the basis of early clinical trial data. The main aim is to meet the needs of patients facing exceptional challenges i.e., those with seriously debilitating or life-threatening diseases and no satisfactory treatment alternative.
Firth, I., Schirrmacher, H., Zhang, K., Towse, A. and Hampson, G.
Gene therapies represent a paradigm shift in medicine, with the potential to address the root causes of chronic diseases. They offer one-time treatment regimens and, in some cases, potentially a cure. As a result, they offer transformative value for patients, physicians, health systems and society. However, with the prospect of more gene therapy approvals there is concern in Europe that these technologies could threaten the financial sustainability of health systems.
Berdud, M., Jofre-Bonet, M., Rodes-Sanchez, M., Towse, A.
After the shock caused by the first wave of COVID-19, discovering vaccines against the virus and administering them quickly to the population became the utmost priority worldwide, especially once subsequent waves of COVID-19 were inevitable. Not only incentivising the research on vaccines and authorising them quickly, but managing optimally the portfolio of vaccine candidates and establishing an efficient distribution plan became paramount to the success of this instrument.
We have now published an interactive report on our recent debate, The Promise of Gene Therapy: Are we Ready?
In a webinar held on 16 March 2021, Mary Harney, Annie Hubert and Simone Boselli joined OHE’s Adrian Towse to debate the issues surrounding the adoption of gene therapies. In the interactive report we highlight our 5 key takeaways from the debate with clips, quotes and highlights.
Cubi-Molla, P., Mott, D., Henderson, N., Zamora, B., Grobler, M. & Garau, M.
OHE explores the values of life that are used in analyses by the governmental departments of health, social care, environment, and transport, for a range of countries: Australia, Canada, Japan, New Zealand, South Korea, The Netherlands, and the UK. In most of the countries explored in this report, there is evidence that the criteria for resource allocation used by government or its agencies in the health sector values life significantly lower than the other non-health departments. The authors present a theoretical model which suggests that the existence of different values of life across departments is not inconsistent with the idea of optimal resource allocation (in a static model) but only if perfectly counterbalanced by non-health attributes. Notably, some form of reconciliation is needed to correct the potential imbalance in the value of the same attribute (life) across public sectors. Reconciliation could range from reallocation of budgets, transfers of benefit, to adjustments of benchmarking thresholds.
The COVID-19 pandemic has revealed the broad and devastating health, economic and societal impact of a highly infectious and deadly disease. In addition to the human suffering of COVID-19 patients, the pandemic is taking a heavy toll patients’ families, friends, colleagues, and other social networks. On healthcare staff working around the clock, wave after wave. And on the capacity of the NHS, buckling under the pandemic pressures with consequences that will last for years. Then, there’s the disastrous economic impact, crippling economies in the UK and worldwide.
Towse, A., Lothgren, M., Steuten, L. and Bruce, A.
Using medicines in combination can deliver better outcomes for patients across different tumour types and disease stages. Yet many HTA agencies do not find that the expected additional benefits from adding a new medicine to a currently reimbursed medicine represents value for money to the health system. In markets that utilise cost-per-QALY approaches for assessing value, a clinically effective medicine might even be found to be “not cost-effective at zero price” when used as part of a regimen that increases treatment duration.
By convention, values for generic ‘preference-based’ measures, such as the EQ-5D, are anchored at 1 = full health and 0 = dead. This paper challenges the assumption that anchoring health state values at ‘dead = 0’ is a necessary condition for values to be used in quality-adjusted life year (QALY) estimation. The authors consider five propositions, using narrative review of the literature and conceptual explication of the problem: