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Everyone would like to shorten that time span. But the information we have about just how long medical research does take to bear fruit is surprisingly hard to use to inform research policy and practice. Different studies measure elapsed times between different points in the research history of an innovation. They also measure elapsed times for a wide variety of very different kinds of innovations with rather different pathways between initial inspiration and eventual delivery of benefits: medicines, public health interventions, better ways to organise health services, and numerous other kinds of health care technology improvement.

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Editor’s Note: Making Sen$e Social Security columnist Larry Kotlikoff recently returned from Rome, where he spoke with Italy’s new economic minister. From the outside, it’s easy to assume that Italy, with 13 percent unemployment, is in bad shape, beholden to the more economically stable Germany. But that’s a strange world, argues Kotlikoff, because Italy is actually in much better fiscal shape than its Teutonic brethren are.

– Simone Pathe, Making Sen$e Editor

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Quoted author: Lawrence Kotlokoff



The 21st OHE Annual Lecture was given by Professor Anne Mills, London School of Hygiene and Tropical Medicine, on the subject of Universal Health Coverage in low- and middle-income countries. It is now available as a publication and can be downloaded here.



The Office of Health Economics (OHE) has posted a new item entitled ‘Recently published: new report comparing usage of medicines in the UK with other countries’.

Just published is an analysis for the ABPI by Phill O’Neill and Jon Sussex of the Office of Health Economics. They have estimated the quantities of medicines used per head of population in the UK and 12 other high income countries. This updates to 2012/13 the 2008/09 analysis which was published by the UK Department of Health in the 2010 Richards Report: “Extent and causes of international variations in drug usage: A report for the Secretary of State for Health by Professor Sir Mike Richards CBE.

This analysis highlights the usage of important classes of medicines in the UK relative to 12 comparable high-income countries including France, Germany, Italy, Spain and the USA. Sixteen classes of medicines were included in the original Richards report covering key primary care and secondary care therapy areas such as cardiovascular and cancer.

Access the OHE analysis here.



That was the title of James O’Mahony‘s seminar, earlier today (a pdf version of his presentation can be found here). The talk focussed on a review of the choice of comparator strategies in cost-effectiveness analyses, specifically in the case of human papillomavirus (HPV) testing in cervical screening. In his presentation, James reviewed a set of published model-based cost-effectiveness analyses of cervical screening programmes (mostly from US/Europe), using HPV testing to investigate what screening strategies were chosen for analysis and how this choice might influence estimates of the incremental cost-effectiveness ratio (ICER).

The main point of the talk was that in many cases the ICER estimates (as presented in the literature) are most probably lower than would be estimated had more comparators been included. A particular problem appears to be the omission of strategies with relatively long screening intervals of 5 years of more. This can lead to the unreliable estimation of cost-effectiveness for the most policy-relevant strategies, which are those with ICERs around the cost-effectiveness threshold. Consequently, such cost-effectiveness analyses may not be providing the best possible policy guidance and lead to the mistaken adoption of cost-ineffective screening strategies. The seminar was the first of a new series on statistics/health economics talks, at University College London.