Health Economics

Increasing demands and limited budgets with which to meet them are a familiar challenge that policy makers in health care face. Clinical research is often carried out to determine the efficacy of a policy or intervention by measuring the effect it has on patient outcomes. However, effectiveness alone is not always enough to justify a policy or the use of a technology. For example, when the most effective intervention is also the most expensive it may not be possible to treat every patient.

Health economics aims to tackle this issue by offering policy makers insight into how cost effective a health care policy or intervention is. It does this through a process called economic evaluation.

An economic evaluation compares treatment options by gathering and assessing data on their costs, and the consequences that they have on health outcomes. This typically involves determining the resources needed to deliver an intervention compared to alternatives, benefits to patients, and any savings to future health care or social care that may occur as a result of the intervention. The results of the evaluation are then used by health care policy makers to decide which interventions to adopt.

LRiG has over two decades of experience of working on economic evaluations for Health Technology Assessment (HTA) on behalf of the National Institute for Health and Care Excellence.

Rui Duarte leads the economic evaluation alongside clinical trials workstream within the LRiG health economics team. The health economists at LRiG have a wealth of experience of teaching health economic principles to a range of audiences; students, healthcare professionals, statisticians and systematic reviewers. Bespoke workshops or training programmes can be developed. We can provide advice on the design of the health economic component of studies and provide economic support to the LCTU.

Recent Health Economics publications

Lead-I ECG for detecting atrial fibrillation in patients with an irregular pulse using single time point testing: a systematic review and economic evaluation

The research reported in this issue of the journal was commissioned and funded by the HTA programme on behalf of NICE as project number 16/30/05. Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is associated with an increased risk of stroke and congestive heart failure. Lead-I electrocardiogram (ECG) devices are handheld instruments that can be used to detect AF at a single time point in people who present withrelevant signs or symptoms. This study aimed to assess whether or not the use of lead-I ECGs in GP surgeries could benefit these patients and offer good value for money to the NHS.

Health Technology Assessment. 2020; 24 (3). Rui Duarte. Janette Greenhalgh. Marty Chaplin. Sarah Nevitt. Angela Boland.

A systematic review of health state utility values for thyroid cancer

Health state utility values are commonly used to inform economic evaluations and determine the cost-effectiveness of an intervention. The aim of this systematic review was to summarise the utility values available to represent the health-related quality of life (HRQoL) of patients with thyroid cancer. This study provides a catalogue of utility values for use when carrying out economic modelling of thyroid cancer. By including mapped values, this approach broadens the scope of health states that can be considered within cost-effectiveness modelling.

Quality of Life Research. 2020; 30, 675–702. Rachel Houten. Nigel Fleeman. Angela Boland. Tosin Lambe. Rui Duarte.

A Systematic Review of Economic Evaluations Reporting the Cost-Effectiveness of Spinal Cord Stimulation

Spinal cord stimulation (SCS) is a recognized treatment for chronic pain. This systematic review aimed to assess economic evaluations of SCS for the management of all chronic pain conditions, summarize key findings, and assess the quality of studies to inform healthcare resource allocation decisions and future research. The results consistently suggested that SCS is cost-effective when considering a long-term time horizon, particularly for the management of FBSS and CRPS. Further studies are needed to assess the cost-effectiveness of SCS for ischemic pain and DPN.

Value Health. 2020; 23, 665. Rui Duarte.

For more examples see the Publications page.