Cubi-Molla, P., Errea, M., Zhang, K. and Garau, M.
Cost-Effectiveness Thresholds (CETs) are used in a selected number of countries as tool in decision-making on funding and reimbursements for new healthcare technologies. In this white paper, OHE presents an analysis of the relative merits and shortfalls of current approaches to defining, estimating and applying CETs in Health Technology Assessments. The paper also puts forward a number of policy recommendations to help guide decision makers in ensuring CETs are used to achieve improved health outcomes in the future.
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.
Henderson N., Errea M., Skedgel C. and Jofre-Bonet, M.
In light of concerns that not all medicines for ultra-rare (also known as ultra-orphan) conditions are appraised under the same NICE process, a new OHE Consulting Report discusses the distinct ethical and economic challenges faced by medicines for ultra-rare conditions, with particular reference to the challenges of HTA in the UK. A failure to consistently consider all ultra-rare disease medicines under the HST process could lead to inequalities in access and health outcomes for patients with ultra-rare conditions.
Shah, K.K., Ramos-Goñi, J.M., Kreimeier, S. and Devlin, N.J.
To date there have been no value sets to support the use of the EQ-5D-Y in cost-utility analysis. Discrete choice experiments (DCEs) can be used to obtain values on a latent scale, but these values require anchoring at 0 = dead to meet the conventions of quality-adjusted life year (QALY) estimation. This Research Paper describes a study in which four stated preference methods for anchoring EQ-5D-Y values were compared: visual analogue scale, DCE (with a duration attribute), lag-time TTO and the recently developed ‘location-of-dead’ (LOD) element of the personal utility function approach.
Antimicrobial resistance (AMR) is a growing public health threat, limiting the ability of health care systems to prevent and treat infections and save lives. In parallel, global antibiotic development pipelines are weak. Various R&D incentives have been proposed to address the challenges associated to low economic returns from investment in antibiotics. Value assessment methods recognising the value of new antibiotics to the whole health system are needed to help match the size of the required monetary incentives to the value that they offer.
Yasunaga, H., Yamana, H., Rodes Sanchez, M. and Towse, A.
In 2015, OHE Consulting published a report on data governance arrangements for real-world evidence (RWE) covering the specifics under which RWE was used in eight different countries: Australia, France, Germany, Italy, Sweden, the Netherlands, the UK and the US1. Two years later, Lilly commissioned a second report based on the South Korean setting, following the same method and structure as the original2.
In England, an estimated 378,427 people receive palliative care each year in a range of specialised and generalised services. Overall, the quality of palliative care in England and the wider UK is widely regarded as excellent. However, despite the generally high level of care, many patients receiving palliative care die in pain every year. Yet, to date, there is little evidence of the scale of this problem. This study estimates that currently there are approximately 125,971 end-of-life patients receiving, or in need of, palliative care suffering from unrelieved pain.
Berdud, M., Wallin-Bernhardsson, N., Zamora, B., Lindgren, P., and Towse, A.
The present work aims to assess the life-cycle value of innovative medicines based on the example of Second-Generation Antipsychotics (SGA). Assessing the entire life-cycle of SGA, the study explores how much additional value has been delivered through additional approved indications for SGAs, generic competition or new and clinically superior formulations launched. Using risperidone as representative of the SGA class and comparing it to haloperidol – its counterpart from the First-Generation Antipsychotics (FGA) – this research estimates the life-cycle cost-effectiveness of the SGA class against FGA class in incremental terms. It also estimates the absolute social value added, measured by the sum of the consumer and producer surpluses. Study results aim to quantify the nature of value added by pharmaceutical innovation over the long-run to support consideration as to how access decisions can be informed by these life cycle effects.