Title: Policy Research Unit in Economic Evaluation of Health and Care Interventions
Funder: Department of Health (England)

Abstract: In the current economic climate the efficient and equitable use of scarce health and social care resources is paramount. Cost pressures continue to be felt by the NHS to fund new medical technologies, including pharmaceuticals, and important service developments in mental health, public health and social care. For the Department of Health (DH) to respond to the challenges of ‘Equity and Excellence: Liberating the NHS’ and the Wanless report ‘Securing Good Health for the Whole population’ and to improve their use of scare resources requires better evidence on the costs, cost effectiveness and the consequences for equity of alternative options for providing services. The DH requires ready access to a Unit with expertise in the range of techniques required to conduct the economic evaluation of health and care interventions in order to inform policy development. It also requires a Unit able to apply the latest techniques in modelling and evidence synthesis to make the best use of evidence to meet the challenges of policy making in this area. The aim of the Unit is to assist policy makers in the Department of Health, NHS and social services to make best use of scarce resources by providing: 1) A fast and responsive programme of work to meet the Department’s more immediate policy requirements; 2) A broad programme of applied work to meet their medium to longer-term needs in key policy areas as they emerge; and, 3) Methods development to better meet the challenges of conducting economic evaluation in health and social services, including areas such as the costs and benefits across sectors, individualised care, outcomes and the value of innovation. The Unit will meet these aims by applying the highest methodological standards appropriate to meeting the needs of policy makers in a flexible, timely and relevant way. The Unit’s applied and methodological work is directed at the evolving needs of policy making in health and social care. The Unit’s programme is informed by this engagement with, and responsiveness to, the needs of evidence-based decisions. The Unit’s research programme will evolve to meet the needs of policy makers, but the programme agreed for the first two years is as follows: Responsive programme: Around 20% of the Unit’s workload is devoted to a rapid response service, which includes scoping studies, rapid reviews (e.g. evidence on relative health benefits by background characteristics), critical appraisal (e.g. economic evaluations of public mental health and early awareness of screening for cancer) and initial economic modelling. Applied programme: Obesity The aim is to develop an economic model to demonstrate evidence-based strategies in obesity to improve allocation of resources at a local community level to support local decision-making. Innovations in Technology Innovations in health may offer immediate benefits but in the case of radically new approaches, full benefits are only realised through future developments. This project will develop fresh approaches to economic evaluation of such technologies. Early Awareness of cancer Projects on the costs and benefits of early awareness services in Bowel and Lung cancer using a whole disease pathway modelling approach There are ongoing discussions with policy makers about possible work in mental health. Methods programme: Individualised Care We aim to develop analyses that will assist in identifying care at the individual patient level taking into consideration their responses to interventions and their preferences with regards to outcomes of therapy. Outcomes a) Examine methods of statistical analyses of Patient Reported Outcome Measures (PROMS) data. b) A project testing the acceptability and feasibility of using PROMS in mental health services (starting with depression managed by community mental health teams). Intersectoral Effects Investigate methods to evaluate the costs and benefits of health and social care that fall across sectors, organisations and people outside the NHS (including the appropriateness of EQ-5D as a measure of health, the time of carers and productivity) and how to take them into account in the assessment of cost effectiveness Value based pricing The aim is to provide evidence on ways to implement aspects of value-based pricing in the NHS (such as burden of illness and a wider social perspective) taking into account the impact of displaced services. The overall aim of this programme is to improve the efficiency and fairness of decision making in health and social care, and thereby improve the health and well-being of the whole population by making the best use of scarce resources. This will be achieved by undertaking flexible, timely and relevant research undertaken to the highest methodological standards appropriate to the policy problem. The results of this work will be fully disseminated through publishing in top peer reviewed journals and making reports (including lay summaries) publically available on its website, meeting with key stakeholders, and holding seminars and workshops for interested parties (with the support of DH).


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES);8.2 HEALTH AND WELFARE ECONOMICS
Health categories: GENERIC HEALTH RELEVANCE