Economics of Health Care Systems

O’Neill, P., Mestre-Ferrandiz, J., Puig-Peiro, R. and Sussex, J.

Research Paper
January 2014

The Pharmaceutical Price Regulation Scheme (PPRS) 2014 Heads of Agreement, announced on 6 November 2013, outlines the terms of the five-year deal between the pharmaceuctical industry and the government in the UK. For the first time, the PPRS caps future growth in the NHS's branded medicines bill, between 2014 and 2018.

Karlsberg Schaffer, S., Sussex, J., Devlin, N. and Walker, A.

Research Paper
December 2013

This research examines the use of QALY thresholds in NHS Scotland in 2012-13 for health services that were "at the margin", i.e. those for which investment or disinvestment was planned or occurred.

The study was based on information from three sources: public information from the Scottish Parliament's examination of the NHS Boards' expenditure plans, interviews with the Finance Directors of Scotland's territorial NHS Boards, and a literature review.

Barnsley, P., Towse, A., Karlsberg Schaffer, S. and Sussex, J

Occasional Paper
December 2013

This paper counters the recently-published recommendation by Claxton et al[1] that NICE should lower its cost-per-QALY threshold from the current £20,000–£30,000 official range to £12,936.

Garau, M., Shah, K., Sharma, P. and Towse, A.

Research Paper
May 2013

Is the Link Between Health and Wealth Considered in Decision Making? Results from a Qualitative Study

O’Neill, P., Mestre-Ferrandiz, J., Puig-Peiro, R. and Sussex, J.

Research Paper
April 2013

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.

Karlsberg Schaffer, S.

Research Paper
February 2013

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.

Baillie, L. and Hawe, E.

Briefing
October 2012

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.

Feng, Y., May, A., Farrar, S. and Sutton, M.

Research Paper
April 2012

In April 2006, payment thresholds were raised for GPs who participate in Scotland’s Ouality and Outcomes Framework.  GPs were required to meet new, higher thresholds on some indicators to receive maximum levels of payment.  In this paper, OHE’s Yan Feng and her colleagues examine whether this change in fact improved GP performance and whether the impact differed across GPs. Specifically, they examine whether low-, mid- and high-performing GPs changed behaviour and, if so, to what extent.

Towse, A., Garrison, L. and Puig-Peiro, R.

Occasional Paper
February 2012

Interest is growing in schemes that involve “paying for pills by results”, that is, “paying for performance” rather than merely “paying for pills”.  Despite its intuitive appeal, this approach is highly controversial and is disliked by many health care providers, policy makers, and pharmaceutical companies.

OHE Commission

Monograph
January 2012

This report is based on the deliberations of the OHE Commission on Competition that was assembled in early 2011 "to consider the circumstances where competition between providers of health care might be both feasible and expected to yield benefits, and where not."

The members of the Commission possessed experience and expertise in competition/regulation economics, NHS economics, health policy, NHS management, and health care provision. Their views on competition in the NHS were divergent, meaning that the conclusions the Commission would reach were far from predetermined.

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