HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Friday, 26 August 2016

Two new ScHARR papers on a framework for developing the structure of Public Health economic models

Dr Hazel Squires
Dr Hazel Squires from HEDS has just published two new papers on a framework for developing the structure of Public Health economic models. The research was funded thanks to a NIHR Doctoral Research Fellowship. The two subsequent journal articles were published in the International Journal of Public Health and Value in Health.The work was undertaken within ScHARR and Hazel’s supervisors - Professor Jim Chilcott, Professor Ron Akehurst, Dr Jennifer Burr and Professor Mike Kelly - also contributed to the papers.

This is the first conceptual modelling framework for Public Health economic evaluation. Public health interventions tend to operate in dynamically complex systems and modelling these interventions requires broader considerations than clinical technologies.

Dr Squires said of her work: “This framework has the potential to help decision makers answer useful questions, improve model verification, validation, credibility, and reusability, guide uncertainty analysis and future research, and to facilitate fair allocation of resources.”

The work was undertaken between 2010 - 2014.

The papers can be accessed at:

A systematic literature review of the key challenges for developing the structure of Public Health economic models

A framework for developing the structure of Public Health economic models.


Thursday, 25 August 2016

CVS Health adds 35 products to list of excluded drugs

NICE take note....complex technology appraisals are not always required.........

From Pharmafile:
American pharmacy chain CVS Health has added 35 products to its list of excluded drugs and will not cover certain diabetes and cancer treatments, in an attempt to tackle “hyperinflationary” drugs and expand access to biosimilars.

The company, which has more than 9600 pharmacy stores, has decided to include Medivation’s cancer drug Xtandi, Sanofi’s insulin Lantus, Novartis’s cancer drug Gleevec and AstraZeneca’s statin Crestor.

The company is also embracing what it calls “the future with biosimilars and follow-on biologics” as it will now cover Sandoz’s biosimilar Zarxio, replacing originator Amgen’s Neupogen. Furthermore, they will replace Lantus with Eli Lilly’s Basaglar, which has been approved as a biosimilar in Europe but not in the US.

Its decision to drop certain drugs was an effort to tackle hyperinflationary pricing. CVS indicates: “On a quarterly basis, products with egregious cost inflation that have readily-available, clinically appropriate and more cost-effective alternatives may be evaluated and potentially removed from the formulary.”

One company, in particular, is singled out in the statement. CVS says: “For example, among the hyperinflationary drugs that will be removed in 2017 is Alcortin A external gel by Novum Pharmaceuticals which saw a price inflation of 2856.8% in the last three years.”

The company believes that is approach to excluding certain drugs will generate total savings of more than $9 billion for clients from 2012 through 2017.

Wednesday, 24 August 2016

EUNetHTA 2016-2020

EUNetHTA’s plan for 2016-2020 has been published.  Anticipated outcomes include:
  • HTA production such as early dialogues, joint rapid assessments, and methodological tools will increase. This joint action will aim for 50 joint products per year by 2020.
  • Increased quality and production of joint products, the uptake and implementation of joint HTA work at the national, regional local level. 
  • Dissemination of health information and knowledge, thus improving policy-and decision-making in the health systems of Member States, which turns into protection of citizens against unsafe or ineffective technologies and improves access to high value health technologies. Ultimately this contributes to improved health of the populations.

Monday, 22 August 2016

PhD studentship in HEDS

We are seeking applications from talented and strongly motivated candidates interested in studying for a Ph.D. The successful candidate will work in a stimulating and exciting environment alongside researchers in the inter-disciplinary department, Health Economics and Decision Science (HEDS).

We invite candidates to form their own research proposal around any area of Health Economics and Decision Science that they are particularly interested in. The HEDS webpages provide further information on areas of research, as do HEDS staff profiles.

The studentship will cover:
  • The standard UK/EU tuition fee for PhD study (International Students welcome to apply if you can demonstrate that you are able to make up the difference in fees)
  • Annual tax-free maintenance stipend at the standard UK Research Council rate (currently £14,296 for the 2016/17 academic year)
  • Research Training Support Grant of £750 per year for 3 years
  • The scholarship will fund up to three years full-time study or six years part-time study, subject to satisfactory progress.
Candidates must meet the ScHARR entry criteria for PhD study, namely:
  • Upper Second Class (2.1) Honours degree (you will need to send a copy of your certificate and transcript)
  • Master's degree - good pass/merit (you will need to send a copy of your certificate and transcript)
  • Students whose first language is not English must have an IELTS 7.0 (with 6.5 in each component) OR equivalent gained within the past two years.
The studentship is open to UK, EU and international applicants. Overseas students may apply but would need to fund the fee differential between the Home/EU fees rate and the higher overseas tuition fees rate from another source. This studentship is available for both full-time or part-time (pro-rata) PhD study.

To apply for the studentship, please send your application to Dr Laura Gibson (l.a.gibson@shef.ac.uk).  Please include the following information in your application:
  • Your CV
  • Two recent academic references which should be supplied by academic staff at institutions where you studied previously. If you have been out of education for a while then we will accept a reference from your current employer if they are able to comment on your suitability to study for a higher research degree
  • A short proposal relevant to research in Health Economics and Decision Science (HEDS). Please see this webpage for ideas: https://www.sheffield.ac.uk/scharr/sections/heds/teaching/topics
  • Two named supervisors : The lead supervisor must be a member of staff in HEDS. If after some attempts to contact supervisors you are not having any luck, please contact Dr Laura Gibson (l.a.gibson@shef.ac.uk) who will attempt to pair you up. Once contact with a supervisor has been made, they will be able to provide assistance in writing the proposal
  • Details of your academic qualifications and your English Language proficiency (such a UK A levels, GCSEs, a degree from a UK Higher Education institution, or English language qualifications such as the IELTS exam)
The deadline for applications to be received is Friday 14th October 2016.  Potential candidates are welcome to discuss their application informally with Dr Laura Gibson (l.a.gibson@shef.ac.uk).

Wednesday, 17 August 2016

Visiting Fellow from Hamburg, Germany

Christine Blome joined HEDS in July 2016 as a visiting research fellow for two months. Christine is a psychologist by training; she has been working in patient-reported outcomes and health services research in dermatology (and beyond) since 2008. Currently, she is head of a research group on quality of life research and patient benefit at the University Medical Center Hamburg, and also core member of the Hamburg Center for Health Economics.

During her visit, she is working on a research proposal with John Brazier, focusing on patient preferences for different time patterns of symptoms (EQ-5D; chronic itch) and/or subjective well-being, using both experience sampling and a discrete choice experiment.

In Hamburg, her current work includes:
  • Validation of a diary assessing momentary subjective well-being
  • Quantification of recall bias and scale recalibration bias in the SF-6D
  • Measurement of health-related quality of life and patient-relevant treatment benefit in patients with chronic wounds; multiple sclerosis; skin diseases
  • Qualitative study on patients’ and clinicians’ expectations and experience in relation to biologic treatment for psoriasis
You can contact Chistine for more details via c.blome@uke.de

Monday, 15 August 2016

HEDS work in NICE public health guidance

"Give young people and gay men free condoms to reduce STIs" is how the Guardian reports NICE's latest draft guideline on condom distribution schemes.  A ScHARR team carried out the cost-effectiveness analysis used by the NICE public health advisory committee when making its recommendations.

NICE wanted to understand the potential costs and benefits of schemes which distribute condoms in order to prevent sexually transmitted infections (STIs). ScHARR developed an economic model which took into account the effects on both health and savings to the NHS of these schemes in four populations.

For young people, we replicated the C-card scheme, which is already running in many areas of the UK (for example, the pan-London Come Correct scheme) and aims to increase condom use and reduce condom failure among those aged 13-24. Our analysis estimated that a scheme like the C-card would be cost effective, with a cost of around £17,000 per quality adjusted life year (QALY) gained. Averting cases of HIV was particularly beneficial, since HIV not only reduces quality of life and life-expectancy of patients considerably, but also has high costs to the NHS.

There was limited published evidence from trials of condom distribution schemes on which to base these analyses. For MSM, black Africans and the general population there was a lack of evidence for the effectiveness of schemes in these populations. However, threshold analysis suggested that schemes could be cost-effective in both MSM and black Africans even at quite a high cost (£10 per person in the target population), due in the main to the higher prevalence of HIV in these groups.

Our full report can be viewed here.

Thursday, 11 August 2016

July’s CEAs.....

Our quick search for CEA’s published in July uncovered 38 articles.   In the right-hand column of this blog is a CEA Archive, which includes our CEA search results by month.  Below are those in our areas of interest.
  • Greuter MJ, Berkhof J, Fijneman RJ, Demirel E, Lew JB, Meijer GA, et al. The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis. The British journal of radiology. 2016;89(1063):20150910.
  • Hankin-Wei A, Rein DB, Hernandez-Romieu A, Kennedy MJ, Bulkow L, Rosenberg E, et al. Cost-effectiveness analysis of catch-up hepatitis A vaccination among unvaccinated/partially-vaccinated children. Vaccine. 2016;34(35):4243-9.
  • Kuznik A, Habib AG, Munube D, Lamorde M. Newborn screening and prophylactic interventions for sickle cell disease in 47 countries in sub-Saharan Africa: a cost-effectiveness analysis. BMC health services research. 2016;16(1):304.
  • Verhoef TI, Trend V, Kelly B, Robinson N, Fox P, Morris S. Cost-effectiveness analysis of offering free leisure centre memberships to physically inactive members of the public receiving state benefits: a case study. BMC public health. 2016;16:616.
  • Wong KM, Ding K, Li S, Bradbury P, Tsao MS, Der SD, et al. A Cost-Effectiveness Analysis of Using the JBR.10-Based 15-Gene Expression Signature to Guide Adjuvant Chemotherapy in Early Stage Non-Small-Cell Lung Cancer. Clinical lung cancer. 2016.

Wednesday, 10 August 2016

Latest publications by HEDS

These are the latest publications by HEDS colleagues and collaborators in July.

Ally, A., lovatt, M., meier, P., brennan, A., & Holmes, J. (n.d.). Developing a social practice-based typology of British drinking culture in 2009-2011: Implications for alcohol policy analysis. Addiction.

© Springer Link

Carroll, C. (2016). Measuring academic research impact: creating a citation profile using the conceptual framework for implementation fidelity as a case study. Scientometrics, 1–12. http://doi.org/10.1007/s11192-016-2085-0

Davis, S., & Kua, W. S. (2016). Systematic review of health state utilities in children with asthma (Systematic review of health state utilities in children with asthma). Retrieved from https://www.sheffield.ac.uk/scharr/sections/heds/discussion-papers/16_11-1.580331

Egan, M., Brennan, A., Buykx, P. F., De Vocht, F., Gavens, L., Grace, D., … Lock, K. (n.d.). Local policies to tackle a national problem: comparative qualitative case studies of an English local authority alcohol availability intervention. Health and Place.

© http://www.valueinhealthjournal.com/
   Grimm, S. E., Dixon, S., & Stevens, J. W. (n.d.). When future change matters: modelling future price and diffusion in health technology assessments of medical devices. Value in Health. http://doi.org/10.1016/j.jval.2016.06.002

  Hernandez Alava, M., & Wailoo, A. (n.d.). Fitting adjusted limited dependent variable mixture models to EQ-5D. The Stata Journal.

   Latimer, N. R., Bell, H., Abrams, K. R., Amonkar, M. M., & Casey, M. (n.d.). Adjusting for treatment switching in the METRIC study shows further improved overall survival with trametinib compared with chemotherapy. Cancer Medicine. http://doi.org/10.1002/cam4.643

Moore, H. J., Nixon, C., Tariq, A., Emery, J., Hamilton, W., Hoare, Z., … Rubin, G. (n.d.). Evaluating a computer aid for assessing stomach symptoms (ECASS): study protocol for a randomised controlled trial. Trials, 17(1). http://doi.org/10.1186/s13063-016-1307-3

Uttley, L., Whiteman, B. L., Woods, H. B., Harnan, S., Philips, S. T., & Cree, I. A. (2016). Building the Evidence Base of Blood-Based Biomarkers for Early Detection of Cancer: A Rapid Systematic Mapping Review. EBioMedicine. http://doi.org/10.1016/j.ebiom.2016.07.004

van Hoorn, R., Kievit, W., Booth, A., Mozygemba, K., Lysdahl, K. B., Refolo, P., … Tummers, M. (2016). The development of PubMed search strategies for patient preferences for treatment outcomes. BMC Med Res Methodol, 16(1), 88. http://doi.org/10.1186/s12874-016-0192-5

Monday, 8 August 2016

Last chance to apply for our courses

HEDS runs three Masters courses, a Diploma, a Certificate and allows students to sign up for individual modules.  Many of these can be undertaken online.  Brief details are below, but hurry, there’s not much time to apply as teaching starts at the end of September.

MSc, Diploma or Certificate in International Health Technology Assessment, Pricing and Reimbursement.  This is an online course.  Students can sign up for individual modules too.  The course is most relevant to people working in the biotechnology industry, or organisations dealing with market access or reimbursement decisions.  These are our most accessible and flexible courses.

MSc Health Economics and Decision Modelling.  This is a face-to-face course.  The course is most relevant for people wanting to undertake cutting-edge cost-effectiveness analyses.

MSc Economics and Health Economics.  This is a face-to-face course.  The course is most relevant for people wanting to undertake a range of health economic appraisals, not just those relating to cost-effectiveness analysis of pharmaceuticals.

Further details can be found on their respective web pages.

Wednesday, 3 August 2016

Cochrane Collaboration Issue 7, 2016…

….is complete.  The website now lists new review protocols, but we’ll just flag up the notable reviews; these being……
  • Enzyme replacement therapy for Anderson‐Fabry disease
  • Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults
  • Interventions for improving coverage of childhood immunisation in low‐ and middle‐income countries
  • Rituximab for eradicating inhibitors in people with acquired haemophilia A