Thursday 31 March 2016, 2.00PM to 3.15pm
Speaker(s): Rhiannon Tudor Edwards, Professor of Health Economics, Bangor University
Abstract: Sir Michael Marmot on Desert Island Discs said “if economists recommend policies that hurt children, then they need to change their methods of analysis”. The health economics paradigm of cost per QALY used by NICE needs to be broadened to capture the full inter-sectoral costs and benefits relevant to public health, taking a long time horizon.
Last year Public Health Wales asked me, and two colleagues at CHEME, Bangor University, Lucy Bryning and Huw Lloyd-Williams to write a report on the Return on Investment (ROI) of investing in early years.
ROI is a pragmatic form of CBA but like cost per QALY league tables, ROI estimates must be interpreted in light of varying methods of calculation. HM Treasury is standardising methods to overcome this.
Commissioners require demonstration of anticipated cost savings from prevention and early intervention - which they do not expect from new drugs or surgical interventions in the NHS. The level of cost effectiveness evidence expected to justify spending on early years of life is scant. Commissioners forget that evidence for new drugs is often from RCTs with very short follow up periods. Internationally, as voiced by James Heckman, Nobel prize winning Chicago economist, ROI evidence points to investment from pre-conception to three years through effective universal pre-school opportunities, and targeted, evidenced parenting programmes delivered with fidelity by trained professionals, as being way above current ROI in financial markets. Is this potentially a relevant comparator? Can we expect multiplier effects of targeting resources towards deprived families, and is there a way of positioning investment in children as a legitimate component of wider economic development investment for a country such as Wales, with wider relevance to the UK?
Location: ARRC Auditorium A/RC/014