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Unifying research and reimbursement decisions: examining two case studies

Thursday 10 February 2011, 1.30PM to 2.30pm

Speaker(s): Marta Soares, Claire McKenna, Eldon Spackman, Laura Bojke, Susan Griffin, Stephen Palmer, Karl Claxton

Abstract: Decisions concerning the adoption or reimbursement of health technologies are increasingly being made simultaneously with the requirements for further research.  This is due to the recognition of the potential impact of decision uncertainty.  Since the year 2000, 6% of the National Institute for Health and Clinical Excellence (NICE) appraisals have issued an 'only in research' recommendation (out of a total of 398 appraisals), where the drug or treatment is recommended for use only in the context of a research study.

There has been, however, little or no attempt to define an explicit framework to inform these decisions - and the analysts producing materials for appraisal may not be producing the right summaries to appropriately inform a simultaneous decision on adoption and further evidence collection.

Using case studies of enhanced external counterpulsation (EECP), a non-invasive procedure used to treat chronic stable angina, and clopidogrel for the management of patients with non-ST-segment elevation acute coronary syndromes, we demonstrate the use of a formal conceptual framework.  This framework combines assessments of: i) cost-effectiveness, ii) the need for further evidence, iii) the effect of reimbursement on evidence generation, and iv) losses associated with reversing decisions, in order to provide guidance between the range of possible decisions ('only in research' (OIR), 'approval with research' (AWR), Approve or Reject) that can be considered regarding the approval and need for further research of healthcare interventions.  The case studies are used to illustrate the information and associated analyses which are required to address the key principles of our framework.

Location: Alcuin A Block A019/020

Who to contact

For more information on these seminars, contact:

Francesco Longo
francesco.longo@york.ac.uk
Shainur Premji
shainur.premji@york.ac.uk
If you are not a member of University of York staff and are interested in attending the seminar, please contact
linda.baillie@york.ac.uk so that we can ensure we have sufficient space

Economic evaluation seminar dates

  • 17 March 2011 (Please note change of start time 2.30pm)
    Pedro Saramago Goncalves, CHE
  • 27 April 2011
    Mike Paulden, University of Toronto