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.
Volume 4, Issue 4
Last week, we published a post pondering the role of health economists in the COVID-19 pandemic response. One way in which our methods and mentality can surely be useful is in prioritising COVID-19 vaccination. And so leads the latest issue of PharmacoEconomics – Open, with a commentary on the subject. The authors outline a decision-making process built around a multi-criteria decision analysis (MCDA).
This issue includes the journal’s annual acknowledgement to reviewers, which lists a handful of our contributors, including yours truly. And this issue includes one of those articles that I reviewed during 2020, on an MCDA in the context of treatment for diabetic macular oedema. The study involved a range of stakeholders in a three-stage process of identifying relevant criteria, testing them in a discrete choice experiment, and then deliberating on the findings. In the end, patient safety and improvements in visual acuity were priorities.
There’s not much in this issue on the ‘outcomes’ side of HEOR. There’s just one study reporting on an application of a mapping algorithm to generate utilities from two trials of ragweed allergy immunotherapy. Otherwise, there’s a study on willingness to pay for a QALY in Saudi Arabia. People were asked to value health states associated with colorectal cancer and then the monetary value of moving to full health. The authors cut the data in various ways, finding values of between $19,000 and $58,000 per QALY.
As usual, the journal includes applied costing and cost-effectiveness studies from a wide range of clinical contexts. This issue has articles on non-invasive ventilation, chronic rhinosinusitis, psoriatic arthritis, plaque psoriasis, and automated urine examination. One study reports on an observational cost-effectiveness analysis in the context of COPD. The researchers used data from 14 hospitals in the UK to evaluate costs and mortality associated with ‘care bundles’ for COPD, which were implemented at half of the sites; they weren’t likely to be cost-effective.
A couple of studies focus on costs of illness. One study estimates out of pocket expenses associated with multiple sclerosis. Based on an online survey with 376 patients in France, a person’s average monthly expenditure related to their MS was €127. For many respondents, this included consultations with physicians. A majority of participants reported having to make trade-offs with expenditure on their social life. Another study sought to estimate health care costs attributable to HIV from age 25 to 69. By matching people with and without HIV in claims data from the US, the authors estimated that the cumulative cost for people living with HIV was $1.8 million, which was seven times greater than that for people without HIV.
Finally, the issue includes a study reporting several systematic reviews in non-Hodgkin lymphoma, reviewing evidence on cost-effectiveness, resource use, and health-related quality of life. Also from the context of lymphoma is a report from a NICE technology appraisal.
A lot of topics are covered in this issue of Economics & Human Biology. As has become customary, I’ll start with the COVID-related articles. One study finds that countries and regions with higher rates of intergenerational co-residence have had higher rates of COVID-19 infection, especially across US states. Another study reports on a contingent valuation to identify willingness to pay for COVID-19 testing in Latin America, coming up with a figure of $45.
Though not COVID-specific, a study on the impact of bereavement on cognitive functioning feels particularly timely. The longitudinal analysis finds that the death of a close person is associated with a modest decline in cognitive function among elderly people in Australia. The researchers suggest that the mechanism may be through reduced social engagement. Another longitudinal analysis in this issue identifies the positive impact of physical activity on cognition, using a generalised method of moments estimator to address endogeneity.
Much of this issue is dedicated to the determinants of health outcomes in children. Several studies look at external environmental factors. One analysis, using data from India, presents the negative consequences for child health of political violence and adverse shocks. In essence, political violence is associated with poorer health outcomes and nutrition for children because it limits families’ capacity to deal with drought and illness. Similarly, another study shows that exposure to armed conflict in pregnancy is associated with lower birth weight. Another study looks at the health impact of refugee camps for children in Tanzania, finding that those who were children during the opening of camps (rather than later in a camp’s operation) experienced negative consequences into adulthood.
Other studies focus on maternal factors. One article looks at maternal education and infant health in the US. Previous research has demonstrated that maternal education is predictive of better infant health, but this study shows that the relationship is stronger in poorer areas. Greater access to health care seems to be the explanation. The study also tracks how things have changed over time. Another study focusses on child marriage and teen pregnancy in Bangladesh. Based on data for 300,000 children, the authors estimate that 18,700 deaths of children under five each year are attributable to adolescent pregnancy. Another study on the circumstances of birth shows that the order of birth affects social trust; first-borns are more trusting.
A couple of studies on the intergenerational transmission of health indicators show that obesity is ‘gender assortative’, and that there are global inequities in intergenerational mobility in height. Another study on height shows its role in mate selection, such that men’s gender-role ideology explains their height preferences.
And then there are some studies focussed on schooling. A study from China looks at the impact of school boarding on mental health. It isn’t good, especially for children from wealthier families. Another study evaluates the effect of school food standards on children’s health in the US. The introduction of a new Act in 2010 had the effect of improving children’s diets, despite being partially offset by a shift to less-healthy diets at home.
Rounding out the papers on young people is a study on the role of adolescents’ non-cognitive skills in determining later-life outcomes. The study used data that included measures of conscientiousness, agreeableness, and neuroticism, finding that these traits are predictive of health-related quality of life in later life, especially for people who are less healthy in adulthood.
Over to the adults now, with a study suggesting that home ownership in England is associated with health benefits. The researchers used the ‘Right to Buy’ policy to model the impact of deciding to purchase your home. Their analysis found that home owners were less likely to report having long-term health conditions and more likely to report higher levels of well-being. This may operate via labour market outcomes. In Vietnam, fridge ownership seems to be a more pertinent matter for research. A study in this issue shows that people who own a fridge tend to have a healthier diet.
A few other studies concern labour market outcomes. Analysis of a policy change in France, which reduced the length of the working week, finds that shorter working hours are associated with a decrease in smoking and other positive health impacts. A study from Mexico finds evidence that the provision of free public health care increases internal migration, with the potential for associated labour market benefits. A study using longitudinal data from China looks at the impact of diabetes on employment and other outcomes, using marginal structural models. Diagnosis of diabetes has a significant negative effect on employment probability for women but not men. Another study finds inequalities in the relationship between disability and health care demand, with more well-off people in the UK making greater use of health care.
A collection of studies looks at the effects of ‘sin taxes’. Analysis of a policy change in Colombia shows that an increase in tobacco tax was associated with a 4-5 percentage point increase in illicit cigarettes. The impact of sugary drinks taxes on prices is the subject of two studies. In Seattle, almost all of the tax was passed on to consumers, with some non-taxed beverages also increasing in price. In Brazil, where taxes were actually reduced, the pass-through rate varied according to firm size and to different products. Also from Brazil is a study on socioeconomic inequalities in obesity. Finally, there is a study on the munchies; legalisation of recreational marijuana use in the US was associated with an increase in junk food sales.