One of our Research Associates, Henry Nwankwo, has just heard that his minor corrections on his thesis on feasibility of using the ICECAP-SCM and other economic measures in patients with end stage organ failure have been approved - congratulations Dr Nwankwo!!

At the beginning of 2019, those working or interested in health economics came together to form the Centre for Health Economics at Warwick (CHEW), led by its first Director, Prof James Mason.

Health economics is a relatively young but increasingly important discipline sitting at the interface between social and health sciences. While ‘health’ and ‘economics’ might seem disparate terms, many issues facing health care systems are fundamentally economic. How should resources be provided for an increasingly ageing population? How can we improve the efficiency of the National Health Service (NHS) without jeopardising access and quality of care? Which new expensive cancer drugs should be purchased and what other care will go unfunded as a consequence? Thus, health economists are tasked with helping governments at home and abroad to value and prioritise healthcare services and systems, using a specialised range of research methods and designs. We are also developing new approaches to incorporate wellbeing in economic evaluation.

CHEW helps the NHS to understand the value of new treatments, by contrasting evidence on their effectiveness and cost. We support the NHS and Warwick Clinical Trials Unit in evaluating new technologies, programmes and interventions in a wide range of fields. These include: social care, cancer, emergency and critical care, mental health, musculoskeletal disorders, rehabilitation, paediatrics and reproductive health. Sometimes these clinical trials involve old technologies being used in new ways and sometimes they are truly innovative. For example, rotator cuff tears of the shoulder are common, and sometimes irreparable leading to substantial pain and disability. The START-REACTS trial is evaluating a dissolvable saline filled balloon inserted surgically above the torn tendons to improve joint function, reduce pain and promote healing. The sensitive application of economic analysis within the NHS and the methodological challenges raised are a central theme for CHEW.

In the national context, Warwick Evidence help the National Institute of Health and Care Excellence (NICE) to assess the cost-effectiveness of new drugs seeking reimbursement. This includes detective work, assessing pharmaceutical company submissions to NICE seeking National Health Service (NHS) funding, by critiquing and re-evaluating claims of effectiveness and cost-effectiveness. Often these assessments become negotiations helping the NHS to secure new drugs at an acceptable cost reflecting their value.

Abroad, CHEW has a growing international research programme, with particular interests in infectious diseases and mental health. We work with a number of overseas universities, policy-makers, and funding agencies, to help decide the best way to invest limited health care budgets and meet ambitious goals such as Universal Health Coverage. Recent projects include the NIHR Global Health Research Group on Psychosis Outcomes, where we are developing tools to measure the financial impact of mental illness on vulnerable households in India, and the STREAM trial, where we found that shortened regimens for drug-resistant TB reduced health care costs in Ethiopia and South Africa, and allowed patients to return to work much sooner.

We are interested in policy evaluation methods and their use in understanding and evaluating governmental decision making, which requires drawing on broad economic toolbox. An example of this is supporting the policy decision made this summer to cease importing blood products into the UK for young patients, reversing the preventative policy implemented following the identification of CJD in 1996.

CHEW is an emergent and growing Centre, learning together and exploring new themes: in essence we research the socioeconomic value of health and healthcare, looking at how the valuation problem varies with context and addressing the measurement challenges of impact identification and valuation.

For more information about CHEW please contact Felicity Langer or see our website:

https://warwick.ac.uk/fac/sci/med/research/hscience/healthec

His PhD topic is about the derivation of a preliminary U.K. preference-based tariff for the Short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS) to allow calculation of Mental Well-being Adjusted Life Years (MWALY). The MWALY will be an alternative outcome measure to QALY and it will be used to capture mental well-being benefits in the economic evaluation of mental health promotion interventions. I will be doing different piloting phases during the PhD to validate the proposed methodology to derive the preference-based tariff.

We celebrated in the office with cakes this morning, congratulations Edmund!