Channeling health economics research initiatives to improve decision-making processes in the EU

Abstract

Health economics as a specialization area has rapidly grown during the last 4 decades. Researchers have selected the topics according to a variety of issues, such as general scientific interest, background knowledge, and perceived gaps in the field as well as the relevance of the topics to their jurisdictions, among others. On the part of the health authorities (managers and politicians), they have to cope with a variety of real-life types of problems that need to be addressed. In their daily practice, they have at their disposal instruments and information from the health economics literature to better manage their health systems. Nevertheless, some mismatches exist in the activities developed by these two groups. On the one hand, it is believed that health authorities disregard or do not use all the available information generated by researchers in their decision-making processes. This could be due to either the irrelevance of a given research for a specific health decision or because health authorities simply ignore it. On the other hand, researchers, for whatever the reason, do not address some topics that really matter to health managers and that would potentially improve the general efficiency of healthcare systems and increase social welfare. The interest in assessing the value of research activities in support of health systems policies was highlighted by Buxton and Hanney 2 decades ago [1]. The need to cope with the gap between research and health policy has also been previously acknowledged by some authors and institutions such as the WHO [2–4]. However, the number of studies and their scope have been quite limited (addressing particular health areas such as pain [5], focusing on single Member States’ research needs [6], being descriptive of some situations [7], and dealing with specific research venues—such as the economic evaluation of health technologies [8] and the value of information as a technique to establish research topics in economic evaluation [9]). More recently, Hunter and Brown [10] have reviewed research topics within the field of health management, and Debrand and Dourgnon [11] described the relationships between health economics research and health policies debated in a meeting of experts from several countries; they also emphasized the need for ‘‘using research evidence to produce pertinent and efficient tools for health policymaking.’’ In spite of these efforts, there is a lack of systematic analysis (follow-up or periodic reviews) on this topic so that health research can be channeled to the more useful areas of health policy making. Other authors have recently noted the necessity to fill the gap between health research and policy [12]. Interestingly, health economics scientific policy in most of the EU countries usually relies on public calls as the instruments to channel funds to research programs. However, these programs have vaguely defined goals and are commonly framed in rather general terms, either guided by some leading research teams or by politicians and bureaucrats in charge of the general scientific policy. Health authorities are not usually empowered to decide on or select the guiding principles of the general scientific policy (i.e., the goals of the calls for each program). In this environment, it is a common practice for each research group to participate in the calls by proposing its preferred topics, which usually find a niche that makes their proposal eligible to receive financial aid. One frequent evaluation criterion to evaluate the results of a research project ex-post is to look at the quality of the peer-reviewed F. Antonanzas (&) R. Rodriguez-Ibeas Department of Economics, University of La Rioja, 26004 Logrono, Spain e-mail: fernando.antonanzas@unirioja.es