Chris Sampson’s journal round-up for 12th October 2020

Every Monday our authors provide a round-up of the latest peer-reviewed journal publications. We cover all issues of major health economics journals as well as some other notable releases. If you’d like to write one of our weekly journal round-ups, get in touch.

Health Economics

Volume 29, Issue 10

Are articles included in these round-ups dominated by the US? A short analysis in this issue, on the geography of health economics research, suggests that they might be. Of empirical articles published in Health Economics and Journal of Health Economics since 2010, 37% were based on US data. 11% used UK data. The authors also reveal a tendency that I find particularly annoying; articles based on North American data often fail to mention this in the title or abstract. This is research, not baseball.

The Americans and the Dutch dominate this issue of Health Economics, but there are some papers from less-researched settings. There’s research on tobacco consumption and exposure to campaigns in Pakistan, cash incentives for childhood vaccination in India, and the budgeting system in Taiwanese health care.

Last week’s round-up included a paper on informal care in retirement and this issue includes another. Using SHARE data, the authors found that there is not a simple trade-off between work hours and caring hours. Retirement does not make people more likely to be carers, but it does increase carers’ time spent on informal care. Another continuation from last week’s round-up is a study of home care eligibility in the Netherlands. The paper in this issue is focussed on inequity in use, showing that Dutch policies are broadly effective in allocating according to need, but that some inequalities in use exist along some socioeconomic dimensions.

There’s a lot in this issue on public health. One study investigates the downstream impacts of public health expenditures, using regional variation in the US to identify that $1 of investment is associated with $3 less being spent on medical care.

A couple of papers focus on sugary drink taxes. In one study, the impact of sugary drink taxes in US cities was evaluated using an analysis of household receipts. The authors find that one city (Philadelphia) saw a 28% drop in purchases, whereas there wasn’t such a clear change in the other cities. Another study in this issue can provide some insight into how best to frame a tax, with a discrete choice experiment suggesting that framing sugary drinks taxes as health-related earmarked tax policy could influence people’s choices more strongly. If DCEs are your thing, there’s also a study on the impact of excluded attributes, using an example from chronic lymphocytic leukemia.

Perhaps the most eye-catching title in this issue is for a study on the association between unemployment and waistlines in Brazil. Apparently, unemployment is linked to lower BMI. Maybe this relationship is driven by young men with the munchies; another study in this issue shows that cannabis users take their first jobs sooner and at a lower wage.

Elsewhere, there are also studies on cost-sharing and low-value care, voluntary deductibles in the Netherlands, and an analysis from vulnerable Medicaid patients in the US.

The Milbank Quarterly

Volume 98, Issue 3

This issue kicks off with a broad-brush essay on COVID-19 and future strategies for public health. In a similar vein, there’s an article on the notion of a library of measures for population health measurement. The authors discuss the development of the Well-Being in the Nation framework, which is designed to support the measurement of health improvement across sectors.

The Milbank Quarterly is more justified than HE or JHE in its focus on the US, and so this issue almost exclusively discusses the US context. A couple of papers investigate Medicare programmes, with an empirical study on the shared savings programme and a review study on bundled payments. Also specific to the US is a study of out-of-network air ambulance bills. Of broader relevance is a study on strategic purchasing, with case studies from the US, England, and the Netherlands. The article paints a bleak picture, outlining asymmetries in power and information that hinder success.

A large part of this issue discusses social and political determinants of health. There’s a retrospective piece on health disparities. There’s also a new study on politics and life expectancy, which has attracted a lot of attention because it supports the notion that the Republicans in the US are killing people; states that implemented more conservative policies since the 1970s saw a reduction in life expectancy. Another study looks at the impact of policies relating to gender diversity and has some similar implications. Policies that protect transgender people are associated with an increase in the use of therapy and hormone treatment services. The authors also identify inequities according to race and ethnicity.

Perhaps even more controversial for the American electorate is the notion of subsidising healthy eating. A study in this issue is relatively optimistic, suggesting that a flexible national programme may be feasible by building on existing networks. There is also a proposal for a new conceptual framework for analyses of overdose risk, which highlights the need to recognise the role of social determinants.

PharmacoEconomics

Volume 38, Issue 10

This issue of PharmacoEconomics doesn’t include much of interest to me, but I’ll do my best to provide a useful summary for you, dear reader. The issue is heavy on reviews. Sometimes, I feel as if systematic reviews are the only reasonable basis for evidence-based policy. Other times, I feel as if they’re the Disney remakes of the research world.

There’s a review of perspective and costing in cost-effectiveness analyses, using the CEA Registry. A key finding is one that you probably expect: that many authors aren’t clear enough about the perspective used in their analysis. Of the small number of studies reporting both a health care and a societal perspective, the societal perspective tended to provide a more favourable result (or else why bother, right?). Another methodological review considers guidance on the use of surrogate endpoints in HTA. Some agencies provide detailed and prescriptive criteria, for which other agencies should also aim. There’s also a review of orphan drug approvals to identify market exclusivity and budget impact. The headline finding is that the Orphan Drug Act in the US has facilitated long-term market exclusivity for drugs with a huge budget impact that has prevented the use of cheaper generics or biosimilars. We also have a review of new drug treatments for cardiovascular disease and a review of costs associated with infectious diseases in children in low- and middle-income countries.

If reviews don’t hold enough novelty for you, there is an article on incorporating pharmacometrics in economic analyses. Pharmacometrics is about modelling the effects of drugs to support their development and to determine dosing. It seems a little far-fetched to me, but I’m out of my depth here.

The issue also includes a validation of the Core Obesity Model, an essay on GDPR and the future of research, and a report from a NICE appraisal of cannabidiol in the context of Lennox–Gastaut syndrome and Dravet syndrome.

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  • Founder of the Academic Health Economists' Blog. Principal Economist at the Office of Health Economics. ORCID: 0000-0001-9470-2369

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