Completed Projects

Wider societal benefits (WSBs) of public health interventions
CORE PROJECT
PIs: Dr Shainur Premji and Professor Susan Griffin, Centre for Health Economics, University of York

In 2010 Department of Health considered a system of value based pricing for new drugs. The premise was that if a health intervention increases a person’s net production (their production less their consumption) by improving productivity (formal paid production or informal unpaid activies such as caring) and/or by reducing consumption of care (formal or informal), government services etc., then this would be valued by society as it would convey WSBs and should be reflected in economic evaluation.

Initial work focussed on how improving health altered the net production of patients (the net resource contribution to society). Estimates based on aggregate data were linked to routine information included in health technology assessments (age, gender, health related quality of life and disease). This produced a “multiplier” to calculate WSBs from the quality-adjusted life years used to capture health impacts in standard cost-effectiveness analysis.

The work raised equity concerns, especially the impact of negative net production (negative WSBs) for people in old age. It showed a non-linear relationship between health and WSBs.

It has been argued that a health sector perspective may legitimately focus on health outcomes, and that incorporating impacts on productivity and consumption may be inappropriate. However, this may be less justifiable in public health and social care and where resources are required from local authorities and other bodies who do not have health improvement as the sole objective.

This new project aims to assess the use of WSBs in the economic evaluation of public health interventions, and to consider how to estimate WSBs, and the available evidence. This will entail consideration of what WSBs should capture (what is valued by society distinct from the value ascribed to health). It will also assess how prioritisation of policies based on health and WSBs combined impacts on population health and health inequality compared with prioritisation based on health gains alone; and assess distributional concerns for WSBs, and how this may influence funding decisions.

Principal Investigators

Dr Shainur Premji
Professor Susan Griffin