Value, Affordability, and Decision Making

OHE’s Chris Sampson is leading a new Research Topic published in Frontiers in Health Services, titled ‘Opportunity Costs in Health Care: Cost-effectiveness Thresholds and Beyond’. The Research Topic is open for submissions, and the editors are inviting research and commentary on a range of issues that the OHE team has been tackling for many years.

OHE publishes a consulting report on an expert consensus programme investigating the most appropriate payment models for multi-indication therapies.

Brassel S., Neri M., Schirrmacher H., and Steuten L.


Consulting Report
October 2021

The NHS is facing unprecedented health system pressure, with a record number of patients waiting for care, while their underlying condition is potentially worsening due to exceptionally long waits.

When there is excess demand for health care, treating one patient means losing the opportunity to treat another. These opportunity costs demonstrate the need to consider health system capacity value, one of the so-called "broader value elements" that is often not fully captured in traditional value assessments.

Cole, A., Neri, M. and Cookson, G.

Consulting Report
November 2021

For the growing number of multi-indication medicines, access may be delayed or even denied due to challenges in linking payment with a medicine’s value across those indications. We assembled a broad range of stakeholders to work toward consensus on the challenges and solutions which promote better patient access and sustainable health care and innovation.

Henderson, N., Firth, I., Errea, M., Skedgel, C. and Jofre-Bonet, M.

Consulting Report
September 2021

Medicines for rare and ultra-rare conditions face distinct economic and ethical challenges compared to medicines for more common conditions. These challenges are implicitly acknowledged by the National Institute of Health and Care Excellence (NICE) by providing an auxiliary appraisal route for highly specialized technologies. However, concerns have been raised regarding the appraisals of medicines that don’t meet the strict criteria and are, therefore, evaluated via the standard appraisal route (STA).

The Value in Health May issue includes the paper “How Should the World Pay for a Coronavirus Disease (COVID-19) Vaccine?”. Finalised in December 2020, it includes: an overview of COVID-19 vaccine development; a proposal for a benefit-based advance market commitment (BBAMC) to get the vaccines needed; and proposals for future pandemic preparedness. In this blog, the authors update their thinking to take account of the events of the last 6 months.

Our new paper explores the evidence currently being used to allocate budgets between public sector activities in the UK and its limitations. We argue that there is much that can and should be done to improve the evidence base to inform the allocation of public sector budgets across portfolios. We propose a pragmatic approach to measure and value disparate public sector outputs in a commensurate manner.

In a recently published report, we explore the financial sustainability of gene therapies and highlight the factors that are likely to influence the financial sustainability of this important medical technology.

Berdud, M., Jofre-Bonet, M., Rodes-Sanchez, M., Towse, A. 

Consulting Report
May 2021

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.

A team at the University of York recently published a study in which they sought to generate more reliable evidence to inform the estimation of marginal productivity in the NHS. In our response, published in Medical Decision Making, we suggest that, unfortunately, the estimates provided by the ‘experts’ in the study are of little practical use.


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