Health Economics Consultancy
We aim to make a difference for our clients, people affected and the wider society
We specialise in:
Technologies we have helped to evaluate
Pharmaceuticals
Medical devices
Diagnostics/Laboratory services
NHS services
Assistive Technologies
Medical Imaging
Tele-medicine/health
Self-care programmes
IVF
Research and trials
If you need a Health Economic component to a research proposal or you're looking to carry out the Health Economic components of your clinical trial, please contact us.
Commissioning for Better Health
Case Study - anti-depressants overspend
A Mental Health Trust was overspending on its anti-depressants budget with prescribing per head well over twice the national average. However, its outcomes were worse than national and comparable cluster averages.
A PBMA (Programme Budget Marginal Analysis) exercise was commenced to look at alternatives to the continuous over-prescribing and over-spend and hence a disinvestment in anti-depressant use. Several alternative projects were developed that addressed the mental health of the community and a set of commissioning criteria and business cases developed with stakeholders. Each of these schemes was scored for benefits that matched these criteria and they were also costed. They were then compared for cost-effectiveness (using a visually quick method: see below diagram).
Self-help and community based schemes were more cost-effective than schemes involving professional help. It made economic sense to reinvest some of the resources tied up in anti-depressants. With the funds released from the drug budget some of these new schemes were highly affordable and could improve patient outcomes and community well being.
Maintaining the health of the population requires many choices, ensuring that scarce resources available are used to their best advantage. However, the evaluation of public health interventions is often more complex than conventional health technologies with outcomes and costs lasting over many years and taking different forms. These may be difficult to measure by conventional economic methods.
Taking more physical exercise may translate into reduced risks of weight-related diseases as well as changes in other lifestyle habits such as smoking. Public health initiatives cover a very broad range of social problems and present new problems for health economists. At UEA staff have been at the forefront of developing new methods and evaluating public health programmes. We advise national and international bodies such as NICE and WHO on such public health initiatives.
Case Study 1 - Economic benefits of regular swimming
When the Amateur Swimming Association of Great Britain wanted to know the economic benefits of communities swimming on a regular basis, they asked HEC to help them. Our modelling showed that the cost-effectiveness derived from regular weekly swimming compares very favourably with many other health care treatments in terms of the cost per Quality-Adjusted Life-Year (QALY) and was well within the normal cost-effective range approved by NICE. To be on the safe-side, our results were deliberately conservative assuming low levels of regular swimming.
Knowing how much these activities saved was also useful for demonstrating any future return on investment in public swimming pools. In terms of reduced and avoided chronic diseases such as - CHD, stroke and Type-2 diabetes alone, the savings amounted £1BN hence showing a 'return on investment' to public pools of around £1.5 for every £1 spent.
Case Study 2 - Economic benefits of community sports participation
Sport England recently wanted to know the economic benefits of more public participation in community sports programmes. We helped them build an interactive economic model that allows users to estimate the predicted health benefits in various sports categories and to calculate the financial savings (including some of disadvantages of sports injuries).
Other projects have included an evaluation of a national ‘Walking for Health' initiative and also a Local Authority's "Healthy Café' to improve the eating habits of its population.
Costing mechanics
An economic evaluation starts with accurate and dependable cost estimates. At HEC we have expert cost specialists who can help establish your exact and cost structures and impacts. We can cost care pathways and related interventions. Knowing what things cost to deliver and comparing this with reimbursement is vital when managing a budgets. We can also help you model costs and decide on the optimum mix of inputs relative to outputs.
We can also help health service providers estimate the cost impact of their products in clinical pathways. For example, we recently helped a treatment agency cost its alcohol dependent patients.