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Social Values and Health Priority Setting at UCL

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Catalogue of Case Studies

Case studies provide insight into the challenges of priority setting and into the role that social values play in priority setting decisions.  They offer policy-makers a means of accessing the experiences of others facing similar problems, and they facilitate comparative research. 

Please contribute your own case studies to help us build a rich repository of examples from real experience of priority setting across a wide range of clinical, national and institutional contexts.  We have developed a template for case studies, and for the purposes of comparative study we kindly ask that you utilize this.  The template is downloadable here. We also invite comments on any of the cases featured here.

For further information or to submit your case study or comments, please contact Katharina Kieslich - katharina.kieslich.10@ucl.ac.uk.


Latest Case Studies

Hematopoeitic Stem Cell Transplantation (HSCT) for Severe Thalassaemia in Thailand.

This case is indicative of priority-setting problems which are particularly acute in low to middle income countries where life-saving or life-improving technologies are coming to market but where the infrastructure and financial resources are not yet available to make such interventions available on a large scale (even where cost-effectiveness is proven), thus raising great challenges around issues of equity. Read more (PDF).

Download comment form for this study (Doc).

 

Telaprevir for chronic hepatitis in the UK

The assessment of Telaprevir for chronic hepatitis by the National Institute for Health and Clinical Excellence (NICE) in the UK demonstrates the application of a variety of social value judgments by NICE even in a case where cost-effectiveness was shown to be well below the established threshold. Read more. (PDF)

Download comment form for this study (Doc).

 

Novo Seven in haemophilia: clinical decision making and funding policies in Germany

This case is an example of how a set of very pressing social values challenges can arise out of one individual case at the clinical level. Read more. (PDF)

Download comment form for this study (Doc).

 

Mifamurtide for the treatment of osteosarcoma in the UK

Some medical interventions, particularly those that benefit the young, provide benefits over a long period of time. When appraising such interventions, the practice of NICE in the UK is to discount their costs and benefits. Read more. (PDF)

Download comment form for this study (Doc).

Lucentis for the treatment of Age-Related Macular Degeneration in the UK

The case of Lucentis for the treatment of age-related macular degeneration proved to be controversial for the UK National Institute of Health and Clinical Excellence (NICE). Read more. (PDF)

Download comment form for this study (Doc).

 

Microscopic-Observation Drug-susceptibility (MODS) Testing for Multi-Drug Resistant and Extreme Drug Resistant Tuberculosis in Thailand

The case of MODS testing for Multi-Drug Resistant and Extreme Drug Resistant Tuberculosis in Thailand is one which raises issues of equity in the context of an intervention which provides benefits to both individual patients and to the wider population in terms of preventative public health. Read more (PDF).

Download comment form for this study (Doc).

 

Absorbent Products for Adult Disabled and Elderly Incontinence in Thailand

This case concerns 'adult diapers' on which many elderly and disabled people in Thailand rely to enable them to cope with the problem of incontinence. Currently these products must be purchased by individuals or by households at some cost (an estimated $1200 per year). The imposition of such costs on groups who are already vulnerable and socially disadvantaged raises issues of equity and solidarity. Read more (PDF).

Download comment form for this study (Doc).

 

Lapatanib for the treatment of advanced or metastatic breast cancer

Lapatanib is a drug for treatment of patients with incurable cancer: they are at the end of their lives. The case was considered in light of the 'end of life' criteria introduced by NICE in 2009. Read more (PDF).

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Sunitinib as a first line treatment for advanced and/or metastatic renal cell carcinoma

Sunitinib was the first treatment assessed by NICE under its 'end of life' criteria introduced in 2009. These criteria give special consideration to life-extending treatments for patients with short life expectancy and where patient populations are small, in recognition of the higher costs and innovative nature of some such interventions which put them beyond the range of cost effectiveness ratios normally required by NICE. Read more (PDF).

Download comment form for this study (Doc).

 

Trastuzumab for the treatment of HER-2 positive advanced and/or metastatic gastric cancer

Trastuzumab was assessed under NICE's end of life criteria. It is a case in which, whilst all the end of life criteria were met, nonetheless the treatment was not approved for the whole patient population on the grounds that, even with the end of life weightings, the treatment was still too expensive and did not provide sufficient benefits to justify its costs. Read more (PDF).

Download comment form for this study (Doc).