HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Thursday, 23 March 2017

More NICE methods changes….

…on the back of their consultation reported in two posts in the HEDS blog last year (here and here).  The three key points:
  • Managed access if budget impact is over £20M in any of the first three years was approved.
  • Speedy appraisal and recommendations if the ICER looks to be under £10K.
  • The proposal to have a £100K threshold for (ultra?) orphan drugs got dropped.  In favour of a £300K threshold.  This is not a typo.
Image: Challenge by Conal Gallagher

More details here.

Wednesday, 22 March 2017

CEAs, systematic reviews and epidemiological models in LMICs

To help us keep on top of current research in low and middle-income countries, we are running a monthly search of research that are aligned to our core research interests.  It's a simple search strategy, with those published in February that are most aligned to our interests listed below.  The full list of articles is kept in our "Searches archive" in the right-hand column.
  • Htet KK, Liabsuetrakul T, Thein S. Cost-effectiveness of a new strategy to detect pulmonary tuberculosis in household contacts in Myanmar. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 2017;21(2):181-7.
  • Coffey PS, Brown SC. Umbilical cord-care practices in low- and middle-income countries: a systematic review. BMC pregnancy and childbirth. 2017;17(1):68.
  • Shafie AA, Yeo HY, Coudeville L, Steinberg L, Gill BS, Jahis R, et al. The Potential Cost Effectiveness of Different Dengue Vaccination Programmes in Malaysia: A Value-Based Pricing Assessment Using Dynamic Transmission Mathematical Modelling. PharmacoEconomics. 2017.
  • Hansen KS, Ndyomugyenyi R, Magnussen P, Lal S, Clarke SE. Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda. Health policy and planning. 2017.
  • Njoroge M, Zurovac D, Ogara EA, Chuma J, Kirigia D. Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya. BMC research notes. 2017;10(1):90.
  • Lu S, Ye M, Ding L, Tan F, Fu J, Wu B. Cost-effectiveness of gefitinib, icotinib, and pemetrexed-based chemotherapy as first-line treatments for advanced non-small cell lung cancer in China. Oncotarget. 2017;8(6):9996-10006.
  • Yan X, Gu X, Xu Z, Lin H, Wu B. Cost-Effectiveness of Different Strategies for the Prevention of Venous Thromboembolism After Total Hip Replacement in China. Advances in therapy. 2017;34(2):466-80.
Image: research by Samuel Huron

Tuesday, 21 March 2017

4th EUHEA PhD Student-Supervisor and Early Career Researcher Conference

The 4th EUHEA PhD Student-Supervisor and Early Career Researcher Conference will be held by the University of Lausanne, Switzerland, on the 6th-8th September, 2017.

The conference aims to provide Ph.D. students and early career researchers an opportunity to present their research.  As such it will allow research to be discussed in detail by a senior health economist and fellow researchers with expertise in the area of study.  Furthermore the conference provides an excellent platform to advance one’s research, network with peers, gain new insights, and discuss potential collaborations with others in an area of interest.

Abstract submission is now open and closes on the 3rd April, 2017.  Abstracts are restricted to 500 words and may be submitted by the presenting student or research supervisor (however the student must be indicated on the list of co-authors). Please use this site to submit abstracts and complete as much of the requested information as possible.  Note that a personal conference account is opened when an abstract is submitted that allows revisions to be made.

Image: Switzerland Grunge Flag by Nicolas Raymond

For more information on the conference and key dates please refer to the conference website.

Friday, 17 March 2017

EQ-5D-5L vs 3L: What are the implications for Cost-Effectiveness Estimates?

The NICE Decision Support Unit has just published a report with that very title.  And the answer to the question is….BIG!

“Nine cost-effectiveness studies conducted alongside clinical trials were used as case studies. Each had existing analyses based on patient completion of the EQ-5D-3L instrument. In each case, we used the copula models to generate a revised analysis based on estimated 5L scores. We compared directly-observed 3L and estimated 5L (EQG and NDB) results.

The  5L  instrument  and  associated  tariff  has  the  effect  of  shifting  mean  utility  scores  further up  the  utility  scale  towards  full  health,  and  compresses  them  into  a  smaller  space.  Thus, improvements  in  quality  of  life  tend  to  be  valued  less  using  5L  than  equivalent  changes measured  with  3L.  In  almost  all  cases,  this  means  that  a  switch  from  3L  to  5L  causes  a decrease  in  the  incremental  QALY  gain  from  effective  health  technologies  and  therefore technologies appear less cost-effective. This is true whether the estimation of 5L is based on EQG or NDB data. However, an important exception is where life extension is a substantial element of health gain, the ICER can reduce rather than increase.

Estimated  incremental  QALY  gains  reduced  by  up  to  75%  when  moving  from  3L  to  5L (EQG dataset) or 87% (NDB dataset).”

You can access it here.

Thursday, 16 March 2017

Project update: Treatment of Adrenal Insufficiency in Neonates (TAIN)

HEDS has undertaken work for the TAIN Consortium, a collaborative European research programme whose goal is to create a new, innovative, regulatory approved version of hydrocortisone that can be administered in adrenal insufficiency patients from birth and specifically in the age range 0-6 years.
TAIN was funded by the European Commission through its 7th Framework Programme (Project Number 281654) and was successfully completed on the 30th November 2016 with the submission of a Paediatric Use Market Authorisation (PUMA) application to the European Medicines Agency. 

The end of project meeting was held in Berlin on the 25th January 2017 at Charite University of Medicine in the historic Lecture Hall Ruin.  Collaborators and speakers at the meeting included representatives from the University of Sheffield, Simcyp Ltd (UK), Charite (Germany), Advanced Drug Delivery Technologies AG (Switzerland), GMBH Glatt (Germany), Diurnal Ltd (UK) and Genetic Alliance UK.

The lead collaborator in Sheffield was Professor Richard Ross, with the economic advice provided by Professor Simon Dixon.

Tuesday, 14 March 2017

February’s CEAs.....

Our quick search for CEA’s published in February uncovered 41 articles.   In the right-hand column of this blog is a CEA Archive, which includes our CEA search results by month.  Below are those in our areas of interest.
  • Cookson R, Mirelman AJ, Griffin S, Asaria M, Dawkins B, Norheim OF, et al. Using Cost-Effectiveness Analysis to Address Health Equity Concerns. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2017;20(2):206-12.
  • Cradock AL, Barrett JL, Kenney EL, Giles CM, Ward ZJ, Long MW, et al. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood. Preventive medicine. 2017;95s:S17-s27.
  • Hansen KS, Ndyomugyenyi R, Magnussen P, Lal S, Clarke SE. Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda. Health policy and planning. 2017.
  • Hassmiller Lich K, Cornejo DA, Mayorga ME, Pignone M, Tangka FK, Richardson LC, et al. Cost-Effectiveness Analysis of Four Simulated Colorectal Cancer Screening Interventions, North Carolina. Preventing chronic disease. 2017;14:E18.
  • Keller A, Gericke C, Whitty JA, Yaxley J, Kua B, Coughlin G, et al. A Cost-Utility Analysis of Prostate Cancer Screening in Australia. Applied health economics and health policy. 2017;15(1):95-111.
  • Schechner V, Carmeli Y, Leshno M. A mathematical model of Clostridium difficile transmission in medical wards and a cost-effectiveness analysis comparing different strategies for laboratory diagnosis and patient isolation. PloS one. 2017;12(2):e0171327.

Monday, 13 March 2017

New project: Critical appraisal training for Public Health England

HEDS has been commissioned to provide six critical appraisal courses for Public Health England. Four half-day courses will equip participants with the skills they need to be competent users of research: two courses will focus on qualitative research while the other two will focus on quantitative studies such as RCTs. All courses will help participants to understand two key issues in research quality internal validity - is the research methodologically sound and accurate? and external validity - does the research help us with our own patients/decision making? Two further full-day ‘Training the Trainer’ courses will refresh participants critical appraisal skills and help them to become confident teachers too.

The courses will be running at locations across the UK during February and March. The courses will be lead by Angie Rees (HEDS) with support from various HEDS staff including Sue Harnon, Chris Carroll and Marrissa Martyn St. James.

Thursday, 9 March 2017

Job in HEDS

We are looking for a Project Administrator.  The successful candidate will work on an MRC funded project to develop a new instrument to measure quality of life for use in health and social care.

They will provide administrative support for project activities, for example the process of obtaining ethics and Research & Development (R & D) permissions, setting up recruitment and qualitative interviews, and ensuring that the project meets the required objectives which are delivered within agreed timescales. They will be responsible for setting up the project administrative systems, maintaining regular communications with staff and partner organisations, and for sharing information within the team and with wider partners.

Image: Give me a better job by duncan c

The closing date is 14 March 2017.  Further details are available here.

Measuring and Valuing Health Benefits for Economic Evaluation….

…Second Edition, now available.  Written by John Brazier, Julie Ratcliffe, Joshua Salomon and Aki Tsuchiya.

Measuring and Valuing Health Benefits for Economic Evaluation examines the measurement and valuation of health benefits, reviews the explosion of theoretical and empirical work in the field, and explores an area of research that continues to be a major source of debate. It addresses the key questions in the field including the definition of health, the techniques of valuation, and the problem of choosing the right instrument.

This is an ideal resource for anyone wishing to gain a specialised understanding of health benefit measurement in economic evaluation, especially those working in the fields of health economics, public sector economics, pharmacoeconomics and health services research.”

It’s £39.99, but if you order online at www.oup.com and enter promotional code AMFLY1Q at the checkout, you save 20%.

Image © Oxford University Press

Monday, 6 March 2017

New Project: EUSCREEN

EUSCREEN’s full title is “Implementation of optimized childhood vision and hearing screening programmes in middle-income countries in Europe”

Over the past two years researchers at the University of Sheffield and University of Reading have been working with a large international team on a funding application to evaluate and implement optimised childhood vision and hearing programmes across Europe (the EUSCREEN project).  The EUSCREEN project will take place over four years, starting January 2017.

Across Europe inequity exists in the provision of childhood vision and hearing screening programmes.   High-Income Countries (HICs) have vision and hearing screening programmes, but they vary with regard to age and frequency of testing, tests used, uptake, screening professionals, referral pathway and funding. This makes it difficult for healthcare providers and policy-makers to decide what screening to implement in Low- to Middle-Income Countries (LMICs) and how.

In this study, cost-optimised, evidence-based screening will be implemented in two LMICs, based on collated evidence from existing vision and hearing screening programmes in Europe. A generic strategy for implementation will be developed.  The cost-effectiveness model and the strategy for implementation will be packed into a transferable TOOLKIT that will assist healthcare providers and policy makers worldwide in their decisions to introduce or modify screening programmes, and increase effectiveness, efficiency and equity of child healthcare.

Dr Jill Carlton (ScHARR) and Dr Helen Griffiths (Academic Unit of Ophthalmology & Orthoptics) from the University of Sheffield are leading the work on evaluation of existing vision screening programmes.