Value, Affordability, and Decision Making

The American Society of Health Economists (ASHEcon) announced Patricia Danzon as recipient of the 2020 Victor R. Fuchs Award. This is given to an economist making significant lifetime contributions to the health economics field. Professor Danzon is an internationally recognized expert in the fields of economics of health care, the biopharmaceutical industry, and insurance, including the medical malpractice area where she began her research.

OHE authors develop a supply and demand model of pharmaceutical markets to analyse the social welfare distribution between consumers (payers) and developers (industry) to set an optimal cost-effectiveness threshold (CET).

Zhang, K., Garau, M. 

Consulting Report
May 2020

OHE presents an overview on the use of cost-effectiveness thresholds (CETs) in a number of selected countries in their decision-making process for health technology assessments. In addition to the different levels of CETs in these countries, this review examines whether an explicit or implicit CET is used, and the additional considerations (here termed ‘modifiers’) that are incorporated when funding and reimbursement decisions are made.

The need for social distancing in light of COVID-19 has led to an unprecedented increase in reliance on digital technologies by both health care providers and patients. While the trend towards digitalisation of health care allows for potential improvements in access, its impact on health outcomes and health inequalities must be carefully considered to ensure they contribute to social welfare and not detract from it.

Cole, A., Towse, A., Zamora, B.

Consulting Report
April 2020

Although the science underlying drug development has evolved, there has been little change in how we pay for them. As more and more medicines come to market with multiple indications (or even more importantly the unrealised potentialto treat multiple indications), the way we pay for those medicines becomes critical in making sure we can benefit from them. “Indication-based pricing” (IBP) permits price to vary according to indication and has been proposed to tackle this issue.

Research by OHE and the University of Washington into how uncertainty-related novel elements of value could be included in an Augmented Cost-Effectiveness Analysis has been published in Journal of Managed Care & Specialty Pharmacy (JMCP). The research discusses what has been or could be done to measure these elements and looks at empirical research to date.

Hernandez-Villafuerte, K., Shah, K., Herdman, M., and Lorgelly, P.

Consulting Report
March 2020

Meningococcal disease is a life-threatening infection and can result in severe sequelae. Recent scientific and technical advances have led to the discovery and implementation of novel meningococcal vaccines which have resulted in a substantial reduction in the burden of disease worldwide, representing a major public health achievement (Crum-Cianflone and Sullivan, 2016).

OHE has published a white paper discussing the relative merits and shortfalls of current approaches to defining, estimating, and applying cost-effectiveness thresholds in HTA.

This will be accompanied by a (forthcoming) research paper exploring bargaining in threshold setting

Cubi-Molla, P., Errea, M., Zhang, K. and Garau, M.

Consulting Report
February 2020

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.

Smith, P.

Seminar Briefing
February 2020

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.


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