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 30, Issue 1
The latest issue of Health Economics includes several articles on the topic of multi-sectoral evaluation. One study seeks to marry QALY-based analyses with consumption value, for an overall measure of wellbeing effects in economic evaluation. The researchers call it OQoL: overall quality of life. In essence, it scales consumption value over time, in a similar way to health-related quality of life. It relies on the identification of some ‘new’ parameters, which could be observed in available data but which ultimately rely on normative judgments. They are i) elasticity of the marginal value of consumption, ii) minimal consumption for a life barely worth living, and iii) standard consumption for a good living standard. The authors helpfully explain how their framework compares to other approaches to capturing broader outcomes in economic evaluation.
An applied analysis looks at the multi-sectoral impacts of psychiatric hospital admission. The researchers use a Danish administrative data set that enables them to link admissions data to a range of other sociodemographic variables and behavioural indicators. They find that admission at first contact (compared with later admission) is associated with fewer criminal convictions and increased employment. Also in mental health, there’s an analysis showing the potential for negative health impacts arising from stringent immigration policies.
A key ‘spillover’ between sectors is between health care and social care. A study in this issue provides what might be an unexpected conclusion from England; higher spending on social care is not associated with lower spending in health care. There are, of course, many caveats to this. The authors focus on their methodological advances over earlier work, using a variety of dependent and independent variables and implementing instrumental variables and a dynamic panel model.
Of particular interest to me in this issue is an article that tries to address the political nature of the use of QALYs. The author argues that the use of social tariffs in the valuation of health-related quality of life should be seen as an instrument of democratic participation. This has important implications for how we aggregate health state values and how we come up with an ‘average’ value for a health state.
Various other topics are covered in this issue. A couple of articles address financial protection in health, regarding the trade-off with the level of coverage and in relation to the specification of poverty lines. Other articles assess the effects of minimum age laws for alcohol and the role of addiction in smoking. Some articles are concerned with pharmaceutical company decision-making, covering topics such as patent litigation and regulatory delays. Another study looks at drug labels and prescribing. Other research includes a willingness to pay study with parents of children with asthma and an analysis of hospitals trading off quality and waiting times.
International Journal of Technology Assessment in Health Care
Volume 36, Issue 5
The latest issue of IJTAHC includes several reviews aimed at guiding future HTA policy. A review of economic evaluations in Ghana identified 31 studies, across which 30% of authors were Ghanaian. The paper summarises the methods used in the studies and the data sources, but the key conclusion is that professional capacity is limited. This is, arguably, a necessary challenge to overcome if HTA is to be fully implemented in policymaking. The lead author featured as a Thesis Thursday guest here on the blog, so you can find out more in the researcher’s own words.
On a similar note, a review of quality of life research in South Africa identified some limitations. 104 studies were reviewed and, as in almost all reviews of this nature, the EQ-5D was the most popular instrument. The problem, according to the authors, is that only a minority of these studies are comparative in nature. Even if the values reported are representative of the populations described, their usefulness in the evaluation of technologies may be limited. One other article in this issue is concerned with quality of life data, describing alternative methods for identifying health state utility values for rare diseases.
Another review in this issue seeks to inform the use of performance-based risk-sharing agreements in China. The authors try to identify the conditions under which such arrangements might be successful. Another study from China examines the role of shared decision-making. The researchers surveyed patients and found that patients preferred shared decision-making and that its adoption was associated with higher patient satisfaction and greater likelihood to adopt new technology.
A pair of short articles are concerned with advancement of HTA methods, relating to the use of real-world data for HTA in Asia and of early HTA in innovation decisions. The issue also includes a couple of applied analyses, in head and neck cancer and stem cell therapy.