The 99th Health Economics Study Group (HESG) meeting has just taken place (5-7th January 2022) at the University of Leeds. The HESG always makes for a great conference with excellent discussion and input into ongoing research. This is partly down to the unique set up of the meeting, whereby authors submit their work but they do not give a presentation of it. Instead, a discussant is assigned to read their paper and present a discussion of the research, forming a discussion agenda to encourage the audience to engage and input their thoughts and ideas.
The format truly allows for spontaneous brainstorming among the delegates and more often than not the authors leave with lots of interesting ideas, comments and suggestions to take forward in improving their work.
This Winter we were delighted to have our own Research Fellow, Giovanni Tramonti, representing Edinburgh Health Economics at the meeting. Giovanni was a discussant for a paper and kindly presented Elizabeth Lemmon’s et al’s work in the poster session – “The use of social care services by patients aged 50 and over diagnosed with colorectal cancer in Scotland”.
This work is the first in Scotland to analyse national data on social care service use by patients diagnosed with colorectal cancer. Check out the full poster below (all results are preliminary):
In many countries, economic evaluation is conducted using decision analytic models and must be undertaken in order to assess value for money and to make funding decisions for vaccines and other pharmaceuticals . These analyses are routinely conducted only at a late stage once the vaccine development process is complete or near complete (e.g. after phase III trials). Although economic evaluations are critical to major national funding decisions for vaccines and other drugs, there is currently no systematic planning process to meet their data requirements, which often involve many model inputs of varying uncertainty.
It is not until completion of late stage economic evaluations that we determine if the level of uncertainty in each model input is too large to reliably establish if the vaccine offers value for money. In many cases substantial uncertainty remains when reimbursement decisions are required. At this point, decision makers are faced with a dilemma. They can either recommend the vaccine based on imperfect available data and risk making a suboptimal decision (e.g. over-paying for a vaccine or not funding a vaccine that would be more beneficial than expected) or delay a reimbursement decision until more data are collected. Delays in funding vaccines can result in vaccine-preventable morbidity and mortality, while inefficient allocation of healthcare budgets can lead to less funding for other important healthcare programs.
How can early stage economic evaluation help address this problem?
Using decision modelling and value of information analysis (VoI) early in the development of new technologies has proven an effective way of ensuring that innovation leads to high value interventions for NHS patients. There is an acute need to improve efficiency in the development of new genomic and precision medicine technologies.
With this in mind, the UK National Institute for Health Research launched four Diagnostic Evidence Co-operatives (DEC) in 2013 based at the Universities of Leeds, Newcastle, Imperial College London and Oxford. They were founded on the premise of early academic methodological engagement for programme development. A summary of their experiences in the use of early modelling is now published in the Medical Decision Making journal. Following the success of the original four DECs, the NIHR have launched an expanded network of next-generation DECs called the NIHR MedTech and In vitro diagnostic Co-operatives
Building on the earlier methodological work by Karl Claxton of the University of York and others, the Leeds DEC undertook two proof-of-concept studies led by Peter Hall to better understand the ability of early modelling, VoI and Bayesian Decision Analysis to (a) design a clinical trial of a novel diagnostic technology and (b) shape a diagnostic development portfolio for a specific disease area.
(A) The OPTIMAprelim trial used early modelling and VoI to select highest the priority genomic test from a list that included Oncotype DX, Prosigna and Endopredict, for further study in a randomised controlled trial (OPTIMA) of chemotherapy versus test-directed chemotherapy for early breast cancer.
(B) The AKI-Diagnostics project used clinical pathway modelling to understand the priorities for a UK research programme into diagnostic tests for Acute Kidney Injury in Critical Care.
Hello everyone and welcome! We are the Edinburgh Health Economics (EHE) group, part of Edinburgh Clinical Trials Unit (ECTU), and this is our new blog!
In recent years, our enthusiastic team has been growing. We now feel like it is about time that we shared with you, the research community, some of the work that we have been getting up to. For our first post, we thought that the best thing to do would be to get our Team Leader – Peter Hall – to tell you a bit about our group and our new blog.
Pete has been leading the EHE group, which bases itself within ECTU and the Usher Institute, since it was established in 2015. He is a Reader in Cancer Informatics and Health Economics, and practicing Oncologist at the Edinburgh Cancer Centre. When he isn’t treating patients, cycling to and from meetings, he is lecturing medical students, working tirelessly on one of his many research projects and keeping the EHE group on track.
Here’s what Pete had to say:
“It is an enormous privilege every day to hear the great ideas to solve problems in health economics that our group grapples with. Although Health Economists at our heart, we come from diverse backgrounds. This must be one of the reasons why we end up taking quite novel approaches to solve the established challenges of measuring value in healthcare. The environment we operate in with new data science and informatics opportunities in Scotland really gives the best opportunities to allow each of our members to shine.”
“One of our missions at the moment is to reach out to make sure that everyone knows when and how they should think about Health Economics in their research plans. The answer is ALWAYS and AS EARLY AS POSSIBLE. We hope that this blog will help you start a conversation with us. We would also love to hear from other Health Economists who share our interests.”
“As we look forward to the continuing development of EHE, the future looks bright! We hope you will join us in following this blog as we share and report on our range of activities. To find out more about our team and the projects we are working on, look out for our ‘Team Spotlight’ posts over the next few weeks!”