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Using Evidence To Set Priorities In Health: An Analysis Of Decisions Of The Pharmaceutical Benefits Advisory Committee
Funder
National Health and Medical Research Council
Funding Amount
$174,575.00
Summary
Australia has pioneered the use of rigorous clinical and economic evidence in the evaluation of drugs prior to funding on our nationally subsidised Pharmaceutical Benefits Scheme. In the ten years since the introduction of the requirement that drugs demonstrate cost effectiveness prior to subsidy being granted there has been no formal independent evaluation of the system to assess its performance. This project will examine the recommendations of the Pharmaceutical Benefits Advisory Committee in ....Australia has pioneered the use of rigorous clinical and economic evidence in the evaluation of drugs prior to funding on our nationally subsidised Pharmaceutical Benefits Scheme. In the ten years since the introduction of the requirement that drugs demonstrate cost effectiveness prior to subsidy being granted there has been no formal independent evaluation of the system to assess its performance. This project will examine the recommendations of the Pharmaceutical Benefits Advisory Committee in the last decade and consider the factors that explain those decisions. At times it has been asserted that those decisions have been arbitrary or based on inappropriate considerations such as the financial cost to government or politics of the day rather than the value for money of the drug in question. We will examine the reasons behind the decisions against the objectives of providing access to life enhancing medicines in a cost effective manner. We will look at what are the key determinants of whether a drug is recommended for listing on the PBS or is rejected. A key focus will be on whether those determinants could be described as legitimate in terms of their consistency with the objectives of the scheme. For example whether the main cause of rejection is a lack of high quality evidence on effectiveness- cost effectiveness or simply because of factors such as the high financial cost to government. The project will create a database of all submissions to the PBAC 1992-2004 that will allow us to explore a number of questions about the effectiveness of the decision making process in using evidence on effectiveness and costs in health more broadly as well as those specific to the PBS. In highlighting some of the problems with the evidence and its interpretation the overall aim is to improve the quality of the decision making process in the future.Read moreRead less
National Resource For Public Good, Web-based Investigator-initiated Trials
Funder
National Health and Medical Research Council
Funding Amount
$1,290,000.00
Summary
The facility will provide resources in clinical trials expertise and web-based trials systems to enable investigator-initiated clinical trials of public good. This should ensure that the highest quality of clinical trials research can be undertaken by clinical trials researchers in new and priority health research areas, at any institution throughout Australia. Areas supported through this national resource will include controlled trials of current clinical practice, surgery, new health technolo ....The facility will provide resources in clinical trials expertise and web-based trials systems to enable investigator-initiated clinical trials of public good. This should ensure that the highest quality of clinical trials research can be undertaken by clinical trials researchers in new and priority health research areas, at any institution throughout Australia. Areas supported through this national resource will include controlled trials of current clinical practice, surgery, new health technologies, palliative and supportive care and complementary medicine.Read moreRead less
The Cost-effectiveness Of Early Resuscitation Of Sepsis In Australia - An Economic Evaluation Alongside The ARISE-RCT
Funder
National Health and Medical Research Council
Funding Amount
$115,971.00
Summary
Critical care treatment is expensive and consumes a significant portion of hospital resources. This study will collect cost, survival and quality of life data on a group of sepsis patients enrolled in a trial of strict protocolised treatment versus standard care (the ARISE study). This information will be used to determine how much it costs for each additional survivor with protocolised treatment, and how much it costs for each quality adjusted life year gained with protocolised treatment.
Australian Fisheries Economic Statistics: Stage 1 Scoping Paper
Funder
Fisheries Research and Development Corporation
Funding Amount
$11,578.15
Summary
Objectives: 1. To develop options for an annual economic review and in doing so to assess its usefulness, feasibility, cost, and to determine who should pay
Development Of An Independently Driven Production Reporting And Forecasting Survey For Australian Farmed Barramundi
Funder
Fisheries Research and Development Corporation
Funding Amount
$5,000.00
Summary
For many years the ABFA has been concerned that the industy's own production estimates and forcasts exceed official statisitics. Also, a lack of information about production capacity and production scheduling across the industry has resulted in supplies to market not being synchronised with demand. This has resulted in substantial variabiluity in seasonal price and availablity. This damages the quality brand being built for Australian farmed barramundi and the important attribute of far ....For many years the ABFA has been concerned that the industy's own production estimates and forcasts exceed official statisitics. Also, a lack of information about production capacity and production scheduling across the industry has resulted in supplies to market not being synchronised with demand. This has resulted in substantial variabiluity in seasonal price and availablity. This damages the quality brand being built for Australian farmed barramundi and the important attribute of farmed produce being consistancy of quality, supply and price. This project will supply industy particpants with essential information about likely production volumes and market supplies. the data will enablle farmers to better manage feed regimes, stocking and harvesting to take best advantage of market forecasts. Objectives: 1. Provide accurate data about production of Australian farmed barramundi 2. Provide independent and creditable data about likely future production, current and future stocking and harvest times for Australian farmed barramundi 3. Provide farmers with the capacity better to match production to forecast market conditions Read moreRead less
Developing A Common Outcome Measure For Priority Setting In Health: Validation Of The 'Transfer To Utility' Technique
Funder
National Health and Medical Research Council
Funding Amount
$314,100.00
Summary
The economic evaluation of health programs is a common requirement of funders and purchasers seeking to get the best value from the health dollar. But researchers employ a wide range of disease specific and generic health status instruments to describe trial outcomes, making comparison between diverse interventions difficult. In response to this problem a 'Transfer to Utility' or TTU technique was developed by Dr Segal and colleagues, to translate diverse outcomes reported in clinical trials, in ....The economic evaluation of health programs is a common requirement of funders and purchasers seeking to get the best value from the health dollar. But researchers employ a wide range of disease specific and generic health status instruments to describe trial outcomes, making comparison between diverse interventions difficult. In response to this problem a 'Transfer to Utility' or TTU technique was developed by Dr Segal and colleagues, to translate diverse outcomes reported in clinical trials, into a utility score, so the performance of diverse health interventions can be expressed in cost-QALY and compared. The technique establishes a statistical transformation between instruments commonly used in clinical trials and a utility value. While the technique appears highly useful, based on a priority setting exercise in osteoarthritis enabling 20 disparate interventions to be compared its validity and applicability in other contexts is not established. The purpose of the grant is to explore the TTU technique to i) establish the best method for estimating the regression equation between common health outcome measures and a utility score and validating that method; ii) test generalisability to other disease areas, for which quality of life is the primary objective of management (in stroke, drug dependence and depression), iii) develop and validate a method for translating the most commonly used measure of general health status, the SF-36, into a utility score and iv) illustrate the application of the TTU in comparing intervensions for the prevention and management of depression. The results of the research will be of value to i) decision makers who must compare the performance of medical-health care interventions across a range of diseases and modalities and ii) to clinicians who want to practice evidenced based health care. The potential health gains for the community are substantial, in supporting the redirection of resources to more effective and cost-effectiveRead moreRead less
This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of t ....This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of the benefits and harms of testing and assessing their trade-off; how benefits weigh up against harms. This research is relevant to all partners in healthcare, (consumers, clinicians and policy-makers), who currently are being tested or using tests without being fully informed about the accuracy and effects of these tests.Read moreRead less
FRDC-DCCEE: Climate Change Adaptation - Building Community And Industry Knowledge
Funder
Fisheries Research and Development Corporation
Funding Amount
$300,000.00
Summary
Portfolio scale delivery of maximum outcomes and benefits to fishing communities - ensuring the information reaches the main benefactors. Confusion in community around climate change impacts and adaptation strategies - need for the synthesis of the science and presentation of information in simple language. Confusion in the community re: climate variability vs change. Placing climate change factors in the context of a range of other externalities affecting fishing communities. Ne ....Portfolio scale delivery of maximum outcomes and benefits to fishing communities - ensuring the information reaches the main benefactors. Confusion in community around climate change impacts and adaptation strategies - need for the synthesis of the science and presentation of information in simple language. Confusion in the community re: climate variability vs change. Placing climate change factors in the context of a range of other externalities affecting fishing communities. Need for more adaptable and flexible fisheries management. Need for interaction and interface between conservation and resource use at the community level. Bringing together existing climate change information where appropriate. Consolidating and reducing misinformation and confusion. Deliver regionally while still having an Australia-wide context. Objectives: 1. Increased knowledge and understanding of likely climate change and adaptation measures open to local communities 2. Support of Case Study for Australia in adaptive management that cross correlates regional needs with Australia wide policy and management policies 3. Tailoring the extension and knowledge sharing for regional needs 4. Synthesising, analysing and assisting in adaptation of key climate change information, in the context of external drivers to marine biodiversity and fisheries business Read moreRead less