Thesis Title: Integrating more individualised estimates of costs and effects in economic evaluations in healthcare.
Abstract: Experimental designs in clinical research are commonly focused upon demonstrating that a particular treatment is better on average than an alternative treatment. However, treatment response for some patients will differ markedly from the average. Observed characteristics at a patient level, such as age, sex, ethnicity and severity of disease, may all determine a patient’s response to treatment as well as influencing their cost of care. Identifying baseline covariates in which treatment response may differ markedly from the population average treatment effect is of central interest to policy makers, reimbursement agencies as well as informing clinical decision making in an age of precision medicine. The process of personalisation of care, moving from an average to an individual patient, for clinical outcomes remains elusive in the economic evidence used to support decision-making for the adoption of new technologies. This disconnect can be mitigated by deriving more individualised cost-effectiveness results for use in healthcare. This PhD will apply advanced econometric and big data methods for heterogeneous treatment effects to generate economic results that move beyond simple averages of costs and health outcomes. This will include the i) Early-phase evaluation of novel therapeutics where important clinical and economic information may be imprecise, missing or undefined; and ii) Late-stage evaluation where decision-makers are required to make a choice among alternatives based on the best available clinical and economic evidence at that point in time. Moreover, the PhD will consider patient heterogeneity into distributional cost-effectiveness analysis across multiple outcomes of interest to reduce existing health inequalities. Partnering with Office of Health Economics will assist in the contextualization and dissemination of research results into global health systems from different stakeholder perspectives.
Primary Supervisor: Dr.Joel Smith