The report addresses the implications of NICE appraising treatments for very rare diseases using a cost-per-QALY gained decision rule of the type used by NICE in its Technology Appraisal Programme to appraise therapies for more common conditions.
Cole, A., O'Neill, P., Sampson, C., and Lorgelly, P.
Surgical practice has and continues to develop at a tremendous pace, reflecting the evolving technological landscape as well as the expanding skillset of the surgical workforce. Minimal access surgery (MAS) can offer improved recovery prospects for patients, but uptake in the UK is variable across both procedures and hospitals.
Low levels of mortality are important indicators of societal success. This lecture is about trends in mortality in the white non-Hispanic population in the United States of America (US), a subject which is not only interesting in itself, but also of global significance because we are all wondering whether this could happen to our own societies or to specific groups within them. The lecture was delivered by Professor Case, Sir Angus added some further reflections and then both professors engaged in a question and answer session at the end. The work discussed here, which is part of a much larger research agenda, leads to comparisons between the US and what might be happening in Europe.The authors’ most recent work on the topic of mortality rates is summarised in three papers (Case and Deaton 2015, 2017a, 2017b; there are links to these papers at https://scholar.princeton.edu/accase/publications).
This version of the text is based on a transcript of the lecture and, as such, is often less formal and more colloquial than might be expected in an academic paper.
The CRA Report has an underlying assumption that the EU is as globally competitive in generics and biosimilars as it is in innovative products. There is no evidence to support this. The correct industrial strategy for the EU may well be to focus on the development, manufacture and export of innovative products, rather than on lower value generics where EU global competitiveness appears to be weaker.
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.
Maignen, F., Berdud, M., Hampson, G., and Lorgelly, P.
This report explores the consequences of the exit of the United Kingdom (UK) from the European Union (EU) on public health in the UK and in the EU. It also provides an estimate of the economic impact for pharmaceutical companies.
The centralised procedure was created in 1995 to facilitate access to innovative medicines across the European Union. Since then the scope of authorisation via the centralised procedure has been broadened and made mandatory for orphan and oncology medicines.
We analysed routine funding in the NHS for new medicines recently authorised via the centralised procedure with a particular focus on oncology and orphan medicines. We utilised a database of outcomes of health technology assessment (HTA) evaluations conducted in the UK by NICE, AWMSG and SMC: OHE’s Medicines Tracker. We considered centrally authorised products (CAP) approved between 1 January 2011 and 31 December 2016.
We find that a substantial number of products that received an EU authorisation between 2011 and 2016 were not referred for a HTA evaluation in the UK. We also show that there is both variation across agencies and variation across therapeutic classes in terms of adoption decisions and access across England, Scotland and Wales.
Lee, E.K., Park, J.A., Cole, A., and Mestre-Ferrandiz, J.
In 2015, OHE published a report which set out the core principles that should govern how Real-World Data (RWD) is accessed or generated, and used credibly to generate Real-World Evidence (RWE), thereby working toward a set of “international standards”. The analysis was based on a study of governance arrangements in eight key markets: the UK, France, Italy, Sweden, Germany, the Netherlands, Australia and the U.S.
In recognition of the expanding market for health care data in South Korea, the authors partnered with collaborators from SungKyunKwan University to extend this assessment to South Korea. In this report, the authors outline the current arrangements for the collection, sharing and use of RWD in South Korea, and assess how these compare with an “ideal”, facilitative framework for data governance.
Devlin, N., Shah, K., Mulhern, B., Pantiri, K. and van Hout, B.
Standard methods for eliciting the preference data upon which value sets are based (e.g. time trade-off, standard gamble) generally have in common an aim to ‘uncover’ the preferences of survey respondents by asking them to evaluate a sub-set of health states. The responses are then used to infer their preferences over all possible dimensions and levels. An alternative approach is to ask respondents directly about the relative importance to them of the dimensions, levels and interactions between them