-
Reading Suggestion: Health-Wealth link
Recently published is a paper on the consideration of wider societal effects of health interventions, including productivity gains and savings in non-health sectors, in resource allocation decisions by health technology assessment (HTA) agencies and government departments. The article is authored by OHE’s Martina Garau, Koonal Shah, and Adrian Towse.
There is evidence suggesting that, in certain diseases areas such as Alzheimer’s disease, depression, and breast cancer, health interventions can produce economic gains, including improvements in the productivity of patients and their carers at work, and cost savings to other sectors such as education and social care.
The study included interviews with decision makers and experts in eight countries (Australia, France, Germany, Italy, Poland, South Korea, Sweden, and the United Kingdom).
We found that in the eight countries examined, with the exception of Sweden, considerations of wider societal effects have little to no impact on decision making, from budget setting across ministries to reimbursement decisions on individual therapies.
Our interviews revealed several barriers to incorporating wider effects into decision making, which we grouped into the following themes:
- System fragmentation, related to a persistent culture of silo budgets whereby interlinks between governmental departments’ expenditures are not considered;
- Methodological and data generation issues, such as difficulties in demonstrating with reliable data the impact of a specific treatment on productivity;
- Practical issues due to added complexity if those effects are included in decision making;
- Equity issues if the inclusion of productivity effects favour interventions for working-age individuals;
- Weakness of evidence on the relationship between health and economic growth, which is limited in relation to high-income countries.
We conclude by suggesting ways to overcome these barriers. In countries with established HTA processes and methods allowing the inclusion of wider effects in exceptional cases or secondary analyses, it might be possible to overcome the methodological and practical barriers and move towards a more systematic consideration of wider societal effects in decision making. This would be consistent with principles of efficient priority setting.
Barriers to the consideration of wider societal effects in government decision making are more fundamental, due to an enduring separation of budgets within the public sector and current financial pressures. However, only consideration of all relevant effects of public investments, captured in the medium- and long-term, can lead to the allocation of resources to where they bring the best returns.
The paper, published in the International Journal of Technology Assessment in Health Care, is based on a research study that was funded by Eli Lilly and Company.
Download the full paper here.
Full reference: Garau, M., Shah, K.K., Sharma, P. and Towse, A., 2016. Is the Link Between Health and Wealth Considered in Decision Making? Results from a Qualitative Study. International Journal of Technology Assessment in Health Care, 31(6), pp.1-8.
For further information, please contact Martina Garau at OHE.
Related work:
Johannesson, M., Jonsson, B., Jonsson, L., Kobelt, G. and Zethraeus, N., 2009. Why Should Economic Evaluations of Medical Innovations Have a Societal Perspective? OHE Briefing
- See more at: https://www.ohe.org/news/recently-published-are-wider-societal-effects-considered-healthcare-decision-making#sthash.gamWnotu.dpufFrom the OHE website:
Recently published is a paper on the consideration of wider societal effects of health interventions, including productivity gains and savings in non-health sectors, in resource allocation decisions by health technology assessment (HTA) agencies and government departments. The article is authored by OHE’s Martina Garau, Koonal Shah, and Adrian Towse.
There is evidence suggesting that, in certain diseases areas such as Alzheimer’s disease, depression, and breast cancer, health interventions can produce economic gains, including improvements in the productivity of patients and their carers at work, and cost savings to other sectors such as education and social care.
The study included interviews with decision makers and experts in eight countries (Australia, France, Germany, Italy, Poland, South Korea, Sweden, and the United Kingdom).
We found that in the eight countries examined, with the exception of Sweden, considerations of wider societal effects have little to no impact on decision making, from budget setting across ministries to reimbursement decisions on individual therapies.
Our interviews revealed several barriers to incorporating wider effects into decision making, which we grouped into the following themes:
- System fragmentation, related to a persistent culture of silo budgets whereby interlinks between governmental departments’ expenditures are not considered;
- Methodological and data generation issues, such as difficulties in demonstrating with reliable data the impact of a specific treatment on productivity;
- Practical issues due to added complexity if those effects are included in decision making;
- Equity issues if the inclusion of productivity effects favour interventions for working-age individuals;
- Weakness of evidence on the relationship between health and economic growth, which is limited in relation to high-income countries.
We conclude by suggesting ways to overcome these barriers. In countries with established HTA processes and methods allowing the inclusion of wider effects in exceptional cases or secondary analyses, it might be possible to overcome the methodological and practical barriers and move towards a more systematic consideration of wider societal effects in decision making. This would be consistent with principles of efficient priority setting.
Barriers to the consideration of wider societal effects in government decision making are more fundamental, due to an enduring separation of budgets within the public sector and current financial pressures. However, only consideration of all relevant effects of public investments, captured in the medium- and long-term, can lead to the allocation of resources to where they bring the best returns.
The paper, published in the International Journal of Technology Assessment in Health Care, is based on a research study that was funded by Eli Lilly and Company.
Download the full paper here.
Full reference: Garau, M., Shah, K.K., Sharma, P. and Towse, A., 2016. Is the Link Between Health and Wealth Considered in Decision Making? Results from a Qualitative Study. International Journal of Technology Assessment in Health Care, 31(6), pp.1-8.
For further information, please contact Martina Garau at OHE.
Related work:
Johannesson, M., Jonsson, B., Jonsson, L., Kobelt, G. and Zethraeus, N., 2009. Why Should Economic Evaluations of Medical Innovations Have a Societal Perspective? OHE Briefing
-
Articoli correlati
2permille, 5permille, 8permille, accumulazione, acel, acqua, acquirente unico, adapt, addetti, adeguatezza, adequacy of income, aeeg, agcm, age divide, aging, agricoltura, agsi, ai, aifa, almalaurea, ammortizzatori, ammortizzatori sociali, anac, anpal, ape, appalti, archivio, area euro, arera, arrow, arte, article iv, articolo 18, artificial intelligence, asili nido, assegno di ricollocazione, assicurazione, assistenza, aste, astrid, attivazioni & cessazioni, au, austerità, autonomia, awg, baby boomers, banca centrale, banca d'italia, basic income, basilicata, bce, behavioural economics, benchmark sanitari, benchmarking, benchmarking sanitario, benzina, berlin-washington consensus, bersani, beveridge, bicameralismo, big data, bilancio, bilateralità, biosimilari, biotecnologie, bismarck, bocconi, boeri, bonus renzi, brevetti, brevetto, brexit, bruegel, budget process, calabria, calcolo contributivo, calcolo retributivo, calderoli, camera dei deputati, campagna, campania, capitale cultura, capitale umano, carbone, casa, casa&immobili, cash, cassa integrazione, catalogna, cbo, ce, cesifo, chiesa, cig, cigo, cigs, cina, cingolani, città metropolitane, cittadinanza, clinical trials, coal, codice dei contratti, commercio, commissione cassese, commissione onofri, competitività, comuni, comunicazioni obbligatorie, concorrenza, congiuntura, consumo, contante, conti nazionali, contoannuale, contributo perequativo, convegni e dibattiti, cooperazione, copay, coronavirus, corridoi europei, corte costituzionale, corte dei conti, corte di cassazione, corte di giustizia europea, costituzione, costruzioni, covid-19, covid19, covip, crescita, crisi a confronto, crisi economica, croce, ctfs, cultura, cuneo sul lavoro, damiano, davide colombo, day hospital, dcf economics, debito, debito pubblico, decentramento, decontribuzione, decreto dignità, def, deficit, deflazione, democrazia, democrazia diretta, demografia, demography, dependency ratio, dg energy, diesel, dimensione, dipendenti pubblici, dipendenza strutturale, diritti acquisiti, diritti civili, diritti umani, diritto, diritto costituzionale, diritto ecclesiastico, diritto internazionale, disability, disegno istituzionale, disoccupazione, dispositivi medici, distribuzione del farmaco, distribuzione del reddito, disuguaglianze, divario nord-sud, documentazione, draghi, dual tax, dualismo territoriale, ecb, ecofin, economia comportamentale, economia italiana, economia&architettura, economia&diritto, economia&letteratura, economia&storia, education, efficientamento della pa, eiopa, elderly, elders, elezioni, elezioni 2022, ema, emigrazione, emilia romagna, energia, energy, eni, environment, epl, equità, equivalenti, eredità&donazioni, espanet, esrb, esspros, esternalità, etica&economia, ets, euro, eurobarometro, eurobond, europa, europe, europe-us, european commission, european fiscal board, europei, eurostat, eurozona, evasione, evidence-based-policy, fabbisogni standard, famiglie, farmacie, farmacoeconomia, farmaref, federalismo, federalismo fiscale, fesr, filosofia, financial statistics, finanza pubblica, finland, firma digitale, fis, fiscal compact, fiscal rules, fiscalità, flat tax, foi, fondazione einaudi, fondi pensione, fondi sanitari, fondi welfare, fondo di solidarietà comunale, food tax, fornero, francia, friedman, fsc, fund raising, gare, gas, gasolio, generational divide, generazioni, generici, gentile, geografia economica, geopolitica, germania, giovani, global agewatch index, globalizzazione, gme, going for growth, google trends, gran bretagna, grandi opere, grecia, greece, green pass, grexit, growth, gse, health care, households, housing, hta, human capital, ia, ilsole24ore, imf, immigrazione, impact assessment, imprese, in-kind welfare, in-silico, incentivi, incentivo maroni, india, indicizzazione, industria, inequality, inflazione, infrastrutture, innovation, innovazione, inpdap, inps, inquinamento, insegnanti, internet, invecchiamento, investimenti, ipca, iri, irpef, irpet, isee, islam, iso, istat, istituzioni, it-silc, italia-domani, iue, iva, jaspers, job act, jobs act, kant, karlsruhe, kela, keynes, la buona scuola, laffer, lagarde, lavorareinfo, lavori pubblici, lavoro, lavoro nero, law&economics, lazio, ldi, lea, legge annuale per il mercato e la concorrenza, legge bilancio, legge di bilancio, legge di stabilità, legge elettorale, lep, letteratura, liberalizzazioni, libere professioni, licenziamento collettivo, licenziamento individuale, liguria, llf, lombardia, ltc, lump of labor, m5s, mantoux, marche, marianna mazzucato, marshall, matera, mattarellum, mattei, media, mediooriente, mediterraneo, mefop, mental accounting, mercati finanziari, mercato, mercato del lavoro, meritocrazia, merkel, mes, messina, mezzogiorno, microsimulation, microsimulazione, migrazioni, mimit, mip, miscellanea, mobilità, moneta, moneta digitale, monopolio, monti, mortalità, multipilastro, multipillar, naspi, nato, nber, net pensions, net social expenditure, netflix, nexi, next generation eu, nfa, ngeu, nice, nitti, nobel, nucleare, nudging, obama, obblighi di cittadinanza, occupati, occupazione, ocse, oecd, oecd italy fiche, off-patent, oil, old age, omt, onofri, optimal taxation, optimellum, opzione donna, ordini professionali, ortodossia, osmed, osservatori inps, osservatorio adapt, outlook, output gap, pace, pagamenti elettronici, palestina, panel estimation, parafarmacie, pareggio di bilancio, parlamento, patent, patent-box, patrimonio, patto della salute, patto di stabilità, pay-as-you-go, pay-back, payback, pensionamento flessibile, pensione di cittadinanza, pensioni, pensions, pepp, perequazione, petrolio, pharmaceuticals, piani di rientro, piano juncker, piemonte, pil, pil potenziale, pisa, plastic tax, pnrr, politica, politica & storia, politica industriale, politica internazionale, politica monetaria, political economy, politiche attive del lavoro, politiche passive del lavoro, politics, ponte sullo stretto, population, pos, potenza, povertà, poverty, pressione fiscale, previdenza, previdenza complementare, prezzi, prezzo petrolio, pricing, prima guerra mondiale, primarie, primo pilastro, privatizzazioni, procurement, productivity, produttività, produzione industriale, progetto galileo, progetto mappatura ssr, programma di stabilità, programmi di stabilità, progressività, proiezioni, proiezioni di spesa, projections, proprietà intellettuale, province, pubblica amministrazione, pubblico impiego, public choice, public debt, public economics, public finances, public procurement, puglia, qe, qualità della spesa, qualità delle norme, quest model, quota 100, quota 102, quota 103, r&d, r&s, ragioneria generale dello stato, react eu, recovery and resilience facility, recovery fund, reddito di cittadinanza, redistribuzione, reference pricing, referendum, reggio calabria, regioni, regions, regis, regolazione, rei, relativismo, repository, repower eu, reputation & expectations, residui fiscali, retail commerce, rete, retirement, rfl, rgs, riciclaggio, riforma amato, riforma dello stato, riforma dini, riforma fondiaria, riforma fornero, riforme strutturali, rinnovabili, ripartizione, ripresa, rischio, risparmio, rita, rlf, robotica, rosatellum, rpl, rubrica radio, russia, saldo strutturale, salute pubblica, salvaguardie, sandel, saniref, sanità, schrodinger, scienza delle finanze, scozia, scuola, scuola superiore sant'anna pisa, seconda guerra mondiale, secondo pilastro, self-defeating policy, semplificazione amministrativa, sen, senato, serie storiche, servizi, servizio universale, sespros, severance pay, sicilia, sindacati, sistema delle conferenze, sistema sanitario, sistema sociale, sistemi sanitari, sky-q, snam, social, social exclusion, social expenditure, solvency ii, sommerso&evasione, sose, sostenibilità, sovranismi, spagna, spazio, spending review, spesa farmaceutica, spesa per istruzione, spesa sanitaria, spesa sociale, spid, ssn, ssr, sssup, stacco carburante, staffetta generazionale, standard sanitari, stati uniti, statistics, statuto dei lavoratori, statuto speciale, stem, storia, strade, stress test, structural balance, structural reforms, sud, sugar tax, superbonus, sure, survivors, sustainability, sviluppo, svimez, tableau, tap, tar, target-2, tasi, tassazione, tasse pigouviane, tassi di interesse, tax burden, tax expenditure, tax-deferral, tax-expenditure, taxing wages, ted, telecomunicazioni, teoria economica, teorie economiche, terna, tfr, tfs, thaler, titoli sovrani, titolo v, toscana, trading deregulation, transizione digit, transizione ecologica, transizione green, transizione università-lavoro, trasporti, trattati di roma, trattato di lisbona, trentino alto adige, trickle-down, trips, trivelle, troika, trump, tunisia, tutele crescenti, ucraina, ufficio parlamentare di bilancio, uk, ula, umbria, unconventional qe, undp, unemployment, unemployment benefits, unione europea, unione fiscale, unione monetaria, universal service, universalismo, universalismo selettivo, università, upb, us, us census bureau, vaccinazione, vaccino, varie, veneto, versailles, via della seta, voto, voucher, welfare, welfare fiscale, wellbeing, wellbeing of older people, who, youngsters, zero interest rate policy