uk: 3 PhD Scholarships at Health Economics Research Group [projects: An Investigation into Methods for Measuring QALYs in the Economic Evaluation of Public Health Programmes; An economic analysis of vertical inequity in the use of health care services in England; The iterative evaluation of health technologies during their development and marketed life-cycle] / Brunel University
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1. HERG/MRC Scholarship No 1
This scholarship (available from October 2007) addresses the following subject:
"An Investigation into Methods for Measuring QALYs in the Economic Evaluation of Public Health Programmes"
Overview of thesis
The approach recommended by NICE and other bodies when undertaking cost-effectiveness analyses is to measure the incremental cost per QALY gained of the intervention under study versus an appropriate comparator. In the case of public health interventions the use of QALYs is often problematic due to difficulties in linking the outcomes of interventions, commonly measured at the intermediate level, to the QALYs gained. The aims of this thesis are (1) to investigate methods for estimating the change in HRQOL associated with public health programmes, and (2) to use these methods to assess the incremental cost per QALY gained of public health programmes. The thesis will involve regression analysis of survey data.
Supervisors :
S. Morris, Reader
J. Fox-Rushby, Professor of Health Economics
Contact
Interested applicants are welcome to contact Dr Stephen Morris (Tel +44 (0)1895 265462 Stephen.Morris@ brunel.ac. uk ) or Professor Julia Fox-Rushby (Tel +44 (0)1895 266864 Fax +44 (0)1895 269708 or Julia.Fox-Rushby@ brunel.ac. uk ) for an informal discussion.
2. HERG/MRC Scholarship No 2
This scholarship (available from October 2008) addresses the following subject:
"An economic analysis of vertical inequity in the use of health care services in England"
Overview of thesis
The pursuit of equity is a key objective of many healthcare systems and has received special emphasis in the National Health Service in England. In economic studies of equity in health care use, it is usual to differentiate between inequality (which arises when different individuals consume different amounts of health care), horizontal inequity (when use is affected by non-need variables that ought not to affect use), and vertical inequity (when individuals with different levels of need do not receive appropriately different amounts of health care). There has been little analysis of vertical inequity because, as well as making value judgements about which variables are need variables (and so ought to affect use) and which are non-need variables (and so ought not to), judgements are also required about the way in which use ought to vary among individuals with different needs. The small number of international studies that have investigated the issue test the necessary but
not sufficient condition for vertical equity that use should increase with morbidity. An exception is Sutton (Sutton M. Vertical and horizontal inequity aspects of socio-economic inequity in general practitioner contacts in Scotland. Health Economics 2002; 11: 537-549), who identifies and measures vertical inequity in Scotland using health survey data by imposing a restriction on the health elasticity of health care. Further work on vertical inequity is justified because there are no estimates for England and because horizontal inequity, which has been the focus of previous work, represents only a partial assessment of overall inequity in health care use.
Supervisors :
S. Morris, Reader
M. Buxton, Professor of Health Economics & Director HERG
Contact
Interested applicants are welcome to contact Dr Stephen Morris (Tel +44 (0)1895 265462 Stephen.Morris@ brunel.ac. uk ) or Professor Martin Buxton, Director of HERG ( Martin.Buxton@ brunel.ac. uk ) for an informal discussion.
3. MATCH/HERG PhD Vacancy
Overview of thesis
"The iterative evaluation of health technologies during their development and marketed life-cycle"
Developing a new health technology is costly and risky. Therefore, most medical device companies operate some form of staged decision-making development process that is regularly reviewed and decisions are taken as whether and how to proceed. These decisions are based on the available information regarding costs and potential future benefits of the device. Currently, economic evaluation of health care technologies tends to focus on the period immediately before or after marketing, and principally reflects the growing requirements for cost-effectiveness evidence to meet the decision-making/ advisory needs of central reimbursement or market access agencies and/or the more diffuse needs of specific potential users considering purchase. Production of this evidence may often be the first time that the conceptual framework of economic evaluation has been applied to the product, despite the fact that there have been proposals that economic evaluation should be used iteratively through the product life-cycle, and some reported examples of this happening.
This PhD will review the methods and concepts, including the use of formal Bayesian approaches, to build on the increasing information available as the product is developed. It will aim to characterise what this process might look like in practice and how it might best be used to inform both internal (commercial) decisions regarding the investment in development and trialling of products, and then feed through to provide the basis for appropriate external appraisal of the product. It is anticipated that the thesis will involve one or more examples of the application of this iterative and cumulative process to specific technologies, and the aim will be to indicate how they might be used in practice in a 'routine' context.
Supervisors:
Professor Martin Buxton
Dr. Lotte Steuten
Contact:
Applications should be addressed to the MATCH Project Manager Elizabeth Deadman, School of Information Systems, Computing and Mathematics, Brunel University, Uxbridge, UB8 3PH, email elizabeth.deadman@ brunel.ac. uk
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