A Management View On Health Economics - Case Study On Network Meta Analyses (Nma) For Pulmonary Arterial Hypertension (Pah)

Abstract

Demonstrate the need for re-opening the debate around the different treatment guidelines for Pulmonary Arterial Hypertension (PAH) by asking the question: How much money could the UK NHS potentially save if they had a clear a ranking of the different oral PAH treatments, based on their clinical effectiveness / ICER ratio? Currently the clinical effect ranking of the standard treatments does not exist; there only exists a ranking of costs related to each health technology. Once the clinical effect ranking is established, the intention of this paper is to investigate how this ranking matches/correlates with the ranking of costs and then assess it’s likeky impact on the NHS spending, with the intention of making it more efficient - starting from the hypothesis that the current treatment guidelines will be followed for this disease. Network Meta Analysis using Winbugs (Bayesian, Markov chain model using dedicated software), which allows to make an informed decision on the clinical effectveness ranking of some of the healthcare technologies (active substances) used in the treatment of Pulmonary Arterial Hypertension (PAH). The ranking is then compared with the ICER, currently in use by UK NICE and the treatment guidelines set by the UK NHS. Usug the above methods, the ranking of healthcare technologies (active substances) used in PAH has been establihed and different scenarios have been identified, with regard to increasing efficiency of public healthcare expenditure on PAH. The various scenarios proposed in this analysis, once confirmed, will contribute to a gain in efficency of public healthcare expenditure on PAH in the UK.