Sussex, J., Rollet, P., Garau, M., Schmitt, C., Kent, A. and Hutchings, A.
The purpose of this research is to identify the attributes to include in a value framework for orphan medicinal products (OMPs), determine their relative importance using a multi-criteria decision analysis (MCDA) process, and test whether an MCDA approach can support decision making in practice.
O’Neill, P., Mestre-Ferrandiz, J., Puig-Peiro, R. and Sussex, J.
Medicines account for less than 10% of total NHS expenditure in the UK. Because spending on medicines is easy to separate out, however, this sector continues to come under particular scrutiny in efforts to manage costs. Forecasting spending on medicines can be useful in planning NHS resource allocation. Simple extrapolations of past trends in medicines expenditure, however, are insufficient because they cannot account for shifts in the mix of medicines available on the market or the appearance of generics.
Forecasters predict that the population of people aged 65+ in the UK will double by 2050, constituting a quarter of the total population. This will seriously challenge the NHS and the social care system. The ageing population is expensive: average NHS spending on 65+ households is nearly double that on households under 65 years of age. Formal care provided by the state, however, is not the only resource on which the elderly rely. England alone has nearly six million informal carers.
The UK Government is proposing to include "burden of illness" criteria in its scheme for value based pricing of branded medicines, potentially according higher rewards to medicines that treat more burdensome diseases. The 2010 Consultation Document includes a definition of burden of illness that incorporates both severity (length or quality of life) and "unmet need" (whether and what treatment exists). Little empirical evidence is available, however, on societal attitudes towards these definitions.
Shah, K., Tsuchiya, A., Risa Hole, A. and Wailoo, A.
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.
The cost of R&D for a successful new medicine has been an important policy issue at least since the 1960s. Cost estimates matter not just because of intellectual curiosity or for industry understanding of its performance, but because they are a key aspect of the international debate about the reasonableness of pharmaceutical prices and the magnitude of the long-term investments involved.
The Humble Economist is an outstanding collection of the most important essays by Prof Tony Culyer, a founding father of health economics. It distils a powerful set of ideas that have profoundly influenced health policy and decision making, and shows how reason and evidence can be used to improve decision making in any area of social policy.
In this Seminar Briefing, Ulf Persson recounts Sweden’s experience with its approach to value based pricing (VBP). The model is a flexible approach that gives weight to cost-offsets outside the health sector and emphasises both encouraging innovation and enhancing access through such options as coverage with evidence development. He offers a series of examples to demonstrate how Sweden has addressed issues that any VBP system will face, including access to orphan drugs.
This Briefing extends to 2007 Thomas McKeown’s well-known analysis of changes in life expectancy in England during 1901-1971. It finds that mortality continued to decline after 1971, but that the causes of death have changed.
O’Neill, P., Puig-Peiro, R., Mestre-Ferrandiz, J. and Sussex, J.
Since 1996, in its yearly PPRS Report to Parliament, the Department of Health in England has published international price comparisons of branded medicines used in the primary care setting. OHE Consulting uses the same methodology in this report to update comparisons through 2011.