Welfare, efficiency, equity and possible conflicts; inequal-
ity and the socio-economic ‘gradient’; evaluating efficiency at system level: international comparisons in the developed world; techniques for measuring equity and inequity; evaluat- ing equity at system level: equity in financing arrangements; evaluating equity at system level: equity in service access and delivery; evaluating equity at system level: equity in the dis- tribution of health; institutional arrangements for efficiency and equity; implications for health care financing and delivery systems in the developed world; centralization and decentral- ization in health care; the role and regulation of markets in developed countries.
The pros and cons of setting the value of a cost-effectiveness threshold according to the marginal productivity of the healthcare service and the importance of deliberative decision-making.
A few weeks ago, NICE published its ‘updated principles‘ – a guide to what the Institute takes into account when developing its guidance, and to the “morals, ethics and values” that underpin its recommendations. This follows a public consultation in… Read More »Some reflections on the new NICE Principles
Once a month we discuss a particular research method that may be of interest to people working in health economics. We’ll consider widely used key methodologies, as well as more novel approaches. Our reviews are not designed to be comprehensive… Read More »Method of the month: Distributional cost effectiveness analysis
In this week’s round-up, I highlighted a recent paper in the journal Cambridge Quarterly of Healthcare Ethics. There are some interesting ideas presented regarding the challenge of decision-making at the individual patient level, and in particular a supposed trade-off between achieving… Read More »On the commensurability of efficiency
It is a contentious issue in philosophy whether an omission can be the cause of an event. At the very least it seems we should consider causation by omission differently from ‘ordinary’ causation. Consider Sarah McGrath’s example. Billy promised Alice to… Read More »Are we estimating the effects of health care expenditure correctly?
Newly published research from Chris Bojke and co-authors estimates productivity growth in the NHS from 1998/1999 to 2013/2014. Total output of the NHS comprises both the volume of various services and their quality while inputs are approximated by total expenditure.… Read More »You won’t believe what these NHS productivity statistics mean for health policy!
The cost-effectiveness threshold utilised by health technology assessment agencies, such as NICE in the United Kingdom, below which new medical technologies and interventions are considered cost-effective, is frequently discussed. NICE currently use a threshold of £20,000 to £30,000 per quality… Read More »Do we really need to change the cost-effectiveness threshold?
NICE recently completed their appraisal of the hepatitis C drug sofosbuvir. However, as has been reported in the media, NHS England will not be complying with the guidance within the normal time period. The cost of a 24 week course of sofosbuvir is almost… Read More »Sofosbuvir: a fork in the road for NICE?
The use of labour market outcomes in the Value Based Pricing scheme is inconsistent with the concept of value This year, the Department of Health in the UK will begin using a new system of ‘value based pricing’ (VBP) to… Read More »The ‘value’ in value based pricing
Economics is largely about trade-offs and compromise. Academics study the former but don’t often engage in the latter. In health economics, as in other fields, a key trade-off is between equity and efficiency. We’ve been studying this for a.very.long.time. Despite this, as… Read More »The potential of the super QALY to reconcile the key contentions in health economics