health economics research proposal

Department of Economics and Related Studies

PhD in Health Economics

Our research degree in Health Economics gives you independence to specialise in a topic of your choice. Your degree will provide you with rigorous training in health economics, and how this impacts health service decision-making. During your study, you’ll receive support and guidance from leading academics in the discipline.

Your research

In your first year, you'll take two assessed modules while also beginning work on your research project. These taught modules will challenge you to think critically about complex economic problems, and how to apply quantitative methods to the understanding of economic structures and interactions.

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Taught modules

You'll study two taught modules in Year 1, while beginning work on your research project. You'll pick one of three core modules listed for semester 1, and then Health Economics for Research in semester 2.

• Microeconomics for Research
• Econometrics for Research
• Mathematical Research Methods
• Health Economics for Research

In Years 2 and 3 you will continue to pursue your research project, culminating in the submission of a doctoral thesis. This course includes an additional, optional ‘write up’ year following the end of the formal registration period.

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You’ll be supported by personal supervisors from the Department of Economics and Related Studies and the Centre for Health Economics throughout your research degree. We'll match your research interests to their area of expertise.

Training and support

When you study with us, you’ll be invited to join our Health Economics research cluster  and become a student associate. You’ll play an active role in the meetings, seminars and workshops, developing transferable skills for your future career. You’ll be assigned one or two personal supervisors throughout your research degree, with support from a Thesis Advisory Panel (TAP).

You’ll have access to department-run training workshops, previous examples of which have included:

• Academic Writing (Professor Cheti Nicoletti)
• Conferences (Professor Andrew Jones)
• PhD Exams/Viva (Professor Peter Simmons)
• Presentations (Dr Jorgen Kratz)
• Publishing in Economics Journals (Professor Zaifu Yang)
• The PhD Job Market (Dr Peter Wagner)

Teaching opportunities

We offer our PhD students the chance to become paid graduate teaching assistants (GTAs). The role can provide you with financial support towards the completion of your degree and develop your communication and teaching skills.

All offer holders and current students are invited to apply for GTA positions via email each July.

Course location

This course is run by the Department of Economics and Related Studies.

You’ll be based in the Department of Economics and Related Studies on Campus West. You'll need to be on campus regularly during your first year to attend taught assessments.

Your PhD can be studied through distance learning from Year 2 onwards, subject to supervisory approval before receiving your offer. If you would like to be considered for distance learning, please inform your prospective supervisor(s) during your online interview, and our Postgraduate Research Administrator, Maigen Savory ( [email protected] ).

Entry requirements

Applicants to the PhD in Health Economics are usually required to hold a Bachelors degree in Economics with a 2:1 or 1st class honours (or overseas equivalent), and an MSc in Health Economics, Economics, or a closely related discipline, with a high average mark (60% or above, including at least 60% in the dissertation component).

English language requirements

If English is not your first language you must provide evidence of your ability.

Check your English language requirements

Apply for the PhD

Take a look at the supporting documents you may need for your application.

Find out more about how to apply .

Research proposal

You’ll submit a research proposal alongside your application. Your research proposal should be no longer than 2,000 words, and provide details on:

• Your main research question
• The relevant literature and your planned contribution to the current research in the area
• The econometric and/or theoretical modelling methods you plan to use
• Your data source(s) if you plan on conducting empirical research

As part of your application, you'll be interviewed by one or two academic staff members, including your prospective supervisor(s). The interview will last around 30 minutes to an hour, with plenty of time for you to ask questions and find out what York has to offer.

Before submitting your proposal, we advise you to check that your research fits the Department’s research interests. As part of your application, please nominate at least one preferred supervisor.

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About the Concentration in Health Economics and Policy

The concentration in Health Economics and Policy prepares doctoral students to address the most pressing challenges in health and health care through innovative, rigorous and interdisciplinary research in the field of health economics. This program integrates traditional training in economics with practical training in health policy and health services research to train the next generation of health economists.

The curriculum offers a broad exposure to the health economics literature and public health disciplines, and stresses the policy implications of these fields of research. The curriculum stresses a foundation in applied modern microeconomic theory, economic evaluation, quantitative methods and econometrics, including PhD-level courses from the Department of Economics in the Krieger School of Arts and Sciences.

Doctoral students are paired with a faculty adviser from the Health Economics concentration with similar research interests. Faculty in the Health Economics concentration are working in a variety of research areas including understanding health insurance design, the economic implications of health and health care disparities, market forces and health care prices, pharmaceutical economics, and payment design and access. Doctoral students will also have the opportunity to work with other faculty within the Department, as well as faculty from other Departments including International Health, Population, Family, and Reproductive Health, Biostatistics, the School of Medicine, School of Nursing, the Carey Business School, and the Department of Economics. Students also often work with various centers and initiatives across the University, including the Hopkins Business of Health Initiative.

What Can You Do With a Graduate Degree In Health Economics And Policy?

The program prepares students for successful research careers as health economists. Former students have gone onto careers in academia, government, research-oriented non-profits, and the private sector. Visit the  Graduate Employment Outcomes Dashboard to learn about Bloomberg School graduates' employment status, sector, and salaries.

View a list of selected recent graduates and dissertation titles for the PhD Concentration in Health Economics and Policy.

Curriculum for the Concentration in Health Economics and Policy

Browse an overview of the requirements for this PhD program in the JHU  Academic Catalogue  and explore all course offerings in the Bloomberg School  Course Directory .

Admissions Requirements

For general admissions requirements, please visit the How to Apply page.

Standardized Test Scores

Standardized test scores are  not required and not reviewed  for this program. If you have taken a standardized test such as the GRE, GMAT, or MCAT and want to submit your scores, please note that they will not be used as a metric during the application review.  Applications will be reviewed holistically based on all required application components.

Matthew Eisenberg, PhD, MPhil,

uses applied health economics methods to study how consumers make decisions about their healthcare.

Per the Collective Bargaining Agreement (CBA) with the JHU PhD Union, the minimum guaranteed 2025-2026 academic year stipend is $50,000 for all PhD students with a 4% increase the following year. Tuition, fees, and medical benefits are provided, including health insurance premiums for PhD student’s children and spouses of international students, depending on visa type. The minimum stipend and tuition coverage is guaranteed for at least the first four years of a BSPH PhD program; specific amounts and the number of years supported, as well as work expectations related to that stipend will vary across departments and funding source. Please refer to the CBA to review specific benefits, compensation, and other terms.

Need-Based Relocation Grants Students who  are admitted to PhD programs at JHU starting in Fall 2023 or beyond can apply to receive a need-based grant to offset the costs of relocating to be able to attend JHU.   These grants provide funding to a portion of incoming students who, without this money, may otherwise not be able to afford to relocate to JHU for their PhD program. This is not a merit-based grant. Applications will be evaluated solely based on financial need.  View more information about the need-based relocation grants for PhD students .

Questions about the program? We're happy to help. [email protected]

• Open access
• Published: 12 May 2023

Global trends in the scientific research of the health economics: a bibliometric analysis from 1975 to 2022

• Liliana Barbu   ORCID: orcid.org/0000-0003-0641-7483 1  

Health Economics Review volume  13 , Article number:  31 ( 2023 ) Cite this article

13k Accesses

2 Citations

18 Altmetric

Metrics details

Health science is evolving extremely rapidly at worldwide level. There is a large volume of articles about health economics that are published each year. The main purpose of this research is to explore health economics in the world's scholarly literature based on a scient metric analysis to outline the evolution of research in the field.

The Web of Science repository was used to get the data (1975–2022). The study explores 1620 documents from health economics. CiteSpace software was used to provide network visualisations. Four thousand ninety-six authors, 1723 institutions, 847 journals and 82 countries were involved in the sample. The current research contains a descriptive analysis, a co-authorship analysis, a co-citation analysis, and a co-occurrence analysis in health economics.

Drummond M.F (author), the USA (country), University of London (institution) and Value Health (journal) are among the most important contributors to the health economics literature. Co-authorship analysis highlights that cooperation between authors, institutions and countries is weak. However, Drummond M.F. is the most collaborative author, the USA is the most collaborative country, and University of York is the most collaborative institution. The study offers an image about the most co-cited references (Arrow K.J., 1963), authors (Margolis H.) and journals (British Medical Journal). The current research hotspots in health economics are “behavioural economics” and “economic evaluation”. The main findings should be interpreted in accordance with the selection strategy used in this paper.

All in all, the paper maps the literature on health economics and may be used for future research.

Introduction

The health economy is a branch of the economy that deals with concerns of the production and consumption of health services and healthcare that relate to efficiency, effectiveness, value, and behaviour. Applying economic ideas, concepts, and methods to institutions, actors, and activities that have an impact on people's health is known as health economics [ 1 ]. The health economy is studying how to allocate limited resources to meet human desires in the medical industry and disease care. The health economy often tries to meet the most pressing challenges facing the health system. Studies in health economics provide to decision-makers precious information about the effective use of resources that are available to maximize health benefits.

The health economics is a component of public health, a component that It can be used to examine health issues and medical treatment. Health economists consider the origin of their discipline to Petty W. (1623–1687) [ 2 ] who propose valuation of human life based on a person’s contribution to national production. Arrow K. is credited with creating the field of health economics in a work where he conceptually distinguished between health and other goods [ 3 ]. Since Arrow K.'s fundamental publication on health economics from 1963, the scale of the healthcare sector, the share of public budgets allocated to healthcare, and the body of research on health economics have all increased significantly [ 4 ].

The current pandemic context has proved the need for a functioning public health system capable of meeting any challenges. The World Health Organization report for 2020 presents an examination of 190 nations' global health spending from 2000 to 2018. The report shows that global health spending has increased consistently between 2000 and 2018, reaching $ 8.3 trillion, or 10% of world GDP [ 5 ]. At the level of OECD Member States, the latest estimates show an average increase in health spending of about 3.3% in 2019, whereas health spending as a percentage of GDP stayed about where it had been in prior years, at 8.8% [ 6 ]. These indicators rose sharply in 2020, as economies faced a pandemic. The increases were driven by an increase in the level of allocation of government resources for health, while private spending on health tended to decline. At EU level, the public sector plays a major role in funding health services. In 2/3 of Member States, more than 70% of health spending is funded by the public sector [ 7 ]. In 2020, the EU's overall public health spending was €1.073 billion, or 8.0% of GDP ( https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Government_expenditure_on_health ). For governments, public spending on health is one of the spending categories with the quickest growth.

Health economics is the application of economic theory, models, and empirical techniques to the analysis of decision-making by individuals, health care providers, and governments regarding health and health care. Even though the methodologies are distinct in terms of health care, health economics aims to apply the same analytical tools that would be applied to any good or service that the economy provides [ 8 ]. By offering a clear framework for decision-making based on the efficiency principle, health economics seeks to simplify decision-making [ 9 ]. Extensive government interference, insoluble uncertainty in many dimensions, asymmetric knowledge, barriers to entry, externality, and the presence of a third-party agent are all characteristics that set health economics apart from other fields [ 10 ].

Health economics is the field were interdisciplinarity bring additional value for society. Health economics development has not been without controversy. Health economics refers to a variety of elements that interact to affect the expenses and spending of the healthcare sector. Its controversy rises from the roles of people, healthcare providers, insurers, governmental bodies, and private companies in influencing the healthcare sector expenses. The parties that interact in this field have some conflicting goals. On the one hand, health care policymakers and public hospitals have as objective to provide real value to the patients, to balance public interest and economic restrictions. On the other hand, private hospitals, insurance companies aim to obtain profit for their shareholders. There are several weaknesses that should be rectified in the future. Among weaknesses it can be found deficiencies in the supply of health economists [ 11 ], a lack of financial resource independence between the local and central levels, the key macroeconomic variables' unfavourable behaviour, and the difficulty in developing new financing alternatives [ 12 ]. In addition to having too close relationships to national institutions and sponsors of health economics research, health economics also has excessively loose connections with general economic theory [ 13 ]. Considering increased demands in healthcare services and limited health care budgets, health economics faces real challenges in providing decision making frameworks and there will always be challenging healthcare decisions. Although it has not always been an impartial instrument, health economics does give useful information for policy [ 14 ]. Regarding how well economics integrates with promoting health, there is scepticism, and public health has mixed feelings on the subject. Health economics has been accused of focusing more on the consumption of healthcare services than the creation of healthcare [ 15 ]. Despite several methodological limitations, health economics can provide helpful concepts and principles that aid in comprehending the effects of resource allocation decisions [ 9 ]. All practitioners must have a elementary comprehension of some economic concepts to both understand the helpful ideas the field may provide and recognize its inadequacies.

The main purpose of the research is to examine the health economics literature published worldwide based on a scient metric analysis to outline the development of the field's research. The existence of a multitude of articles published on health economics determines the need to address and measure it quantitatively. Such an analysis is justified by the need must be aware of the current trends and future directions of research in the field of health economics. Health science is evolving extremely rapidly at worldwide level. There is a large volume of articles about health economics that are published each year. Another argument is that there several computer programs which allows for scient metric analysis of health economics publications. This article contributes to the bibliometric literature on health economics by offering answers to the subsequent research inquiries: How scientific production has evolved in health economics? Who are the most important authors and publications in health economics? What are the geographical and institutional hubs of knowledge production in health economics? What kind of collaboration between authors, organizations, and nations are there in the field of health economics research? Which are the most cited authors and the most cited papers, and which are the most attractive journals for publishing research results in health economics? What are the most debated conceptual approaches in health economics?

The remainder of the paper is structured as follows. The second section introduces a short literature review. Research methodology and data collection are presented in Sect. 3. Section 4 contains the quantitative and qualitative scient metric analysis on health economics by using CiteSpace software (descriptive analysis, collaboration analysis, co-citation analysis and keywords co-occurrence analysis). The last part concludes the analysis, presents the research limitations, and describes future directions of research.

Literature background

Although there are thousands of articles published on health economics, very few articles aim for bibliometric analysis of the field and use computer programs. A first article published by Rubin, R. M. and Chang, C. F. (2003) aims at the study of 5,545 indexed articles, in the period 1991–2000, in the EconLit database, in the Health Economics section [ 16 ]. The second study is published by Wagstaff, A. and Culyer, A. J. in 2012 and extends the previous bibliometric research done by Rubin and Chang also based on the articles indexed in EconLit on health, over 40 years [ 17 ]. The third study, published by Moral-Munoz J.A et all in 2020, focuses on articles indexed in the Web of Science, between 2010 and 2019, which have the word "health" and do not use scientometric software [ 18 ].

It would be worth mentioning a descriptive analysis of the field conducted by Jakovljevic M. and Pejcic A. in 2017, but without the use of bibliometric indicators. The authors quantitatively analyze health economics publications by querying the PubMed, Scopus, WoS and NHS economic evaluation Database between 2000 and 2016 and conclude with the existence of an upward flow of health economics publications [ 19 ]. In this context, the proposed research is characterized by focusing on WoS articles that refer strictly to "health economics" and their computer processing to obtain maps and connections between studies.

Research methodology

Research methods.

In the current paper two research methods were used: bibliometric analysis and knowledge mapping. Regarding the first one, it should be mentioned that bibliometric research methods are used delivering quantitative analysis of textual works, in this case publications about health economics. This method allows bibliographic overviews of scientific production in the field. In the scientific community, the technique is increasingly employed to provide details regarding relationships between various groups [ 20 ]. Bibliometric analysis uses statistical tools and different metrics as part of the analysis (frequency/ count, co-citation, co-authorship, co-occurrence, betweenness centrality, citation burst, modularity, centrality, sigma, Silhouette etc.). Bibliometric analysis naturally presents itself as a tool to qualify, then quantify, the study conducted [ 21 ].

Regarding the second one, bibliometric analysis uses a large quantity of information that should be transformed in knowledge. This is done by using data visualization and knowledge maps. An enormous and complex collection of knowledge resources can be more easily accessed and navigated by using knowledge mapping strategies [ 22 ]. Knowledge mapping is the process of making knowledge maps, it makes explicit knowledge graphic and visual. Knowledge maps are static, they are a “snapshot in time” that aids in understanding and organizing knowledge flow for researchers [ 23 ]. A process, method, or instrument called “knowledge mapping” is used to analyse knowledge to find traits or meanings and perceive knowledge in an understandable and transparent way [ 24 ]. One of the advantages of knowledge mapping includes the freedom to combine without restriction, i.e., without restrictions on the number of connections and concepts that can be established [ 25 ].

Data source and search strategy

For this analysis we decided to use one of the most reliable databases: Web of Science (WoS) because it contains a data for large period. The data was retrieved from the Web of Science Core Collection by using title search tool TI = (health economics). The primary literature data were downloaded on 7th of October 2022. The query objective was to integrate in this analysis all research papers related to health economics. We did not introduce any restrictions regarding the topic or time span for searching documents. We intend to have a comprehensive view of the research area and to see its evolution over time. As a result, 2340 documents were retrieved. Among publications about health economics, the most numerous documents are the articles (37.6%), followed by editor materials (19.8%), meeting abstracts (13.9%) and book reviews (13.3%). There are also review articles on the subject, proceeding papers, letters, books, and book chapters which were kept in the sample. The other types of documents were removed resulting a sample of 2305 publications. The language of almost all publications is English (91.4%), followed by German (4.3%). The percentage of publications produced in other languages, such as French, Spanish, Portuguese, Russian etc. is less than 1.5% for each of them. Publications in other languages than English were eliminated, remaining 2108 documents in the sample.

The next step is to identify and remove duplicates by using Excel function (Conditional Formatting – Highlight Duplicate Values), therefore 8 duplicates were removed. In the sample under analysis, a multitude of types of documents indexed in WoS and referring to the concept of health economics can be observed. During the step of checking for duplications, it was found that there are too many duplicates of documents’ title, most of them due to editorial materials or book reviews. This led to a thorough analysis of publication by type of document (eg there are more than 10 reviews for one book or more than 10 editorial materials signed by the same editor). We identified some publications which are irrelevant for the purpose of our analysis. One hundred eighty-six editorial materials without citations and all 286 book reviews were removed resulting 1628 publications. We kept the editorial materials with citation because some of them have more than 100 citations. We searched for anonymous publications, more exactly we looked for incomplete data (author’s name is missing) and we removed 8 documents.

For the remaining documents the "Full Record and Cited References" was downloaded on 13th of October 2022 (txt files) and used as original data for the proposed bibliometrics analysis and science mapping. The final data collection, which consists of 1620 publications, is supported by 16,755 citing articles (excluding self-citations) and has been cited 18,504 times (excluding self-citations), giving it an H-index of 59. The data are statistical analysed by using annual distribution of publications, authors, journals. Co-authorship analysis focuses on collaboration between authors, institutions, and countries. Cited references, cited authors, and cited journal are used in co-citation analyses, and finally, the co-occurrence will integrate keyword in this research.

The graphical representation of selection procedure can be seen in Fig.  1 .

Selection procedure flow chart. Source: Authors

Visualization tools

Bibliometric method needs a certain amount of data to be statistically credible. This is the reason for that computerized data treatment is needed. Moreover, databases contain hundreds or thousands of entries which are analysed by using computer software. There is many bibliometric software, each of them has particularities and weaknesses. CiteSpace was chosen in this study because it is very user friendly, intuitively, and easy to use. CiteSpace 6.1.R2. available for free download at https://citespace.podia.com . A variety of networks created from scientific publications, such as collaboration networks, author co-citation networks, and document co-citation networks, are supported by structural and temporal analysis in CiteSpace. CiteSpace can produce knowledge domain X-rays. The CiteSpace parameters for this investigation were as follows: time-slicing was from 1975 to 2022, years per slice was 1 year, Look Back Years (LBY) = -1, Link Retaining Factor (LRF) = -1. For text processing and links, we preserved the default settings. We used several nodes (authors, institutions, journal, references, keywords) and metrics (such as citation burstiness, Sigma, Silhouette, rad Q, betweenness centrality) depending on the study that was done. Top N% is set to be equal to 100%, Top N is set to be 50, and g-index is set to be 25.

Statistical analysis

The first step to follow in the scient metric analysis is to analyse the evolution of publications’ number in the researched field. The way in which they are distributed over the years indicates the attention that the field of health economics has benefited from and the speed at which its conceptual development took place. The first 3 papers about health economics were published in 1975, indicating the lowest number of annual publications, but also a concept that has existed for over 4 decades. From Fig.  2 , a general upward trend of health economics publications can be observed, but with numerous upward and downward fluctuations, generating sinusoidal cycles with an average duration of 3–4 years. The period 1975 – 1986 is characterized by a very low number of publications, 98 publications written by 110 authors in 12 years, representing 6% of the total sample. The next two decades (1987 – 2006) are characterized by a slightly increasing trend in the number of publications, with an annual average of approximately 23 publications on health economics, reaching a total of 454 publications written by 826 authors and representing 28% of the total number of analysed publications. Cyclical evolution is highlighted by booms in 1987, 1990, 1995, 1999, 2001.

Literature production related to health economics between 1975 and 2022. Source: Authors

The following period, 2007 – 2022 (16 years) is characterized by an upward evolution of the number of health economics publications, 1068 publications with an annual average of 67 articles (3261 authors involved), meaning 2.3 times more numerous as in the previous two decades and representing 66% of the total sample. In 2017, 86 studies on health economics were published, reaching the highest value in the analysed period. The quantitative evolution of publications in health economics it is explained by a higher interest of the researchers and policymakers to explore the benefits of health economics. The need to identify the ways in which health economics contributes to the healthcare system development represent a solid motivation to continue intensive research in the field.

The evolution of the citations’ number follows, like a shadow, the evolution of publications’ number. The upward trend is maintained, also respecting the previously presented temporal distribution, but without cyclical and sinusoidal fluctuations. The evolution of the citations’ number indicates the growing interest of specialists in researching the field, especially after 2000 when a constant and galloping annual increase in citations begins. The last 5 years show a very high interest of researchers and academics in health economics research, with a maximum point in 2021, with over 2000 citations, an evolution argued by the emergence of the global pandemic. All the figures and observations indicate a constant interest in the conceptualization of health economics and foresee a deeper development in the future.

Geographical analysis allows a better understanding of the field. The 1620 publications involved the work of authors from 82 countries. Among them, the first 10 states with significant contributions in the field of health economics stand out: the USA (605 papers), England (400), Canada (115), Australia (103), Netherlands (75), Scotland (64), Germany (59), Switzerland (57), France (47) and Italy (43). 96.8% of all publications were produced by top-10 countries. According to statistics, the USA is the top nation. 37% of all analysed documents are written by American authors, which is 1.5 times more than values recorded by England (rank 2) and 5.2 times more than Canada, rank 3. There are 49 nations where there are fewer than or equal to 5 publications during entire period.

In our study, a sum of 4096 different authors were identified, and they individually published between one and 16 papers, but only 170 persons are co-authors of more than 3 papers. Table 1 lists the top 10 authors with publications about health economics. Drummond M.F. is the leader, even if he published Essentials of Health Economics with his co-author, Mooney G.H., in 1982. He is affiliated to University of Yor (the UK). The top ten most productive authors published 107 articles, which represents 6.6% of the total publications. The most authors (95.8% of all authors) contributed to the health economics research with less than two papers. It should be noted that the number of authors is 2.5 times over the number of papers., which means that publications are made by cooperation between researchers.

From the point of view of affiliation, the 4096 authors belong to 1723 institutions. The top 10 organizations with many health economics articles are University of London (91 publications), University of California System (54), University of York (51), Harvard University (45), University of Birmingham (41), University of Pennsylvania (34), University of Oxford (30), University of Aberdeen (28), University of California Los Angeles (28) and University of Washington (28). The list is dominated by institutions from the UK and the USA. The top-10 institutions contributed to health economics research field by 230 papers which represents 26.5% of total publications.

It is very important to see which journals have published the most articles about health economics. Regarding the publication’s titles, 847 distinct journals published all 1620 documents related to health economics. It should be mentioned that 782 journals (92.3%) published from one to three articles on health economics during 1975 – 2022. Table 2 lists the top 10 most prolific journals, and together they have published 364 articles, which means 43% of all publications in the sample. The leading journal is the Value in Health (Impact Factor = 5.156) with 160 papers meaning 9.8% of all publications from the sample.

Co-authorship analysis

Co-authorship networks and social network analysis are becoming more and more effective techniques for evaluating collaboration patterns and locating top scientists and institutions [ 26 ]. The author collaboration network can help identify authors with high contributions and reveal the co-operative relationships between the authors. By using CiteSpace, the co-authorship network was created without pruning the sliced networks. Co-authors network has 1028 nodes and 1166 links. Figure  3 presents the network between the most collaborative authors in health economics, all of them published 4 or more publications as co-authors. As indicated by the node name, each node represents a different author, and the font size corresponds to the number of publications for each author. The connections made by the co-authorship of researchers are represented by the interconnections between each pair of nodes. The degree of cooperation between the two authors is indicated by the thickness of the link.

The network of authors’ collaboration in health economics. Source: Authors

Co-authors’ map shows that there are not strong collaboration relationships between authors, the network density level is 0.0022. Moreover, they are divided in small research groups and cooperation for research in health economics is insignificant. Top five collaborative authors are Drummond M. (20 publications), Mooney G. (16), Trosch R. (8), Marchese D. (8) and Fuchs V. (8). They are followed by Basu A. (7), Edwards R. (7), Coast J. (7), Peeples P. (7) and Comella C. (6).

In Fig.  3 it can be seen the cooperation between two research teams. These research teams are formed around key authors in health economics and integrated as most collaborative ones. First research team is created around Drummond M. and Mooney G. They published in 1982 and 1983, in British Medical Journal, 9 papers about different aspects of health economics [ 27 , 28 ]. The second research team is created around Trosch R. and Marchese D., who participated between 2012 and 2015 at several annual meeting, conferences, and congresses to present their work about clinical and health economics outcomes registry in cervical dystonia [ 29 , 30 ]. There are 72 scholars as co-authors in at least 3 publications showing a weak cooperation in health economics. From the perspective of citation burst, there are 5 bursting authors with a burst duration between 2 and 8 years: Drummond M. 1981–1999, Mooney G. 1982–1986, Marchese D. 2012–2015, Trosch R. 2012–2015, and Peeples P. 2018–2020. Bust analysis confirms the existence of the two research teams and their period of activity.

We continue exploring the co-authorship analysis by studying the level of cooperation between institutions. For this purpose, we generated a network where the nodes are the institutions, and we did not used pruning methods. The level of cooperation is revealed by the thickness between institutions’ nodes. The network contains 751 nodes, 944 links, and a density of 0.0034. In Fig.  4 are labelled the institutions with more than 4 collaborative papers, the label size is depending on the number of collaborative publications. No institution has a large value of centrality, meaning that cooperation among the analysed institutions is weak, the links are very transparent because of an insignificant number of publications written by collaboration between organizations or universities.

The network of institutions’ collaboration in health economics. Source: Authors

As seen in Fig.  4 , the top-10 most collaborative institutions in health economics area are: University of York (28 publications), University of Oxford (23), University of Pennsylvania (21), University of Washington (20), University of Birmingham (17), Erasmus University (16), Harvard University (16), Bangor University (15), University of California Los Angeles (13) and University of Toronto (12). There are six institutions for which there was identified citation burst as follows: University of Oxford 2016–2020, University of Pennsylvania 2017–2022, University California Los Angeles 2013–2016, King’s College London 2006–2011, London School of Hygiene & Tropical Medicine 2008–2010, University of Washington 2015–2018. Cooperation among institutions is depending on cooperation among authors. It is understood that poor collaboration at the individual level is followed by an identical one at the organizational level.

Progress in any field can be achieved only by communication. Analysing country co-authorship may lead to identification of leading states in health economics research. The visualisation map for country collaboration reveals a network of 202 nodes, 710 links and 0.035 density. It should be noted that country co-authorship network has a density 10 times larger than institutions co-authorship network. The map was generated in CiteSpace without pruning parameter. In Fig.  5 are displayed the countries having more than 5 collaborative health economics-related publications.

The network of countries’ collaboration in health economics. Source: Authors

As can be observed, the biggest nodes correspond to the most prominent and cooperative nations. The collaboration between institutions from these nations is shown by the links between the nodes. The discrepancies between the first two countries and the other states are obvious. The network of the most collaborative country, the USA, consist in 521 publications. It is followed by England with 344 publications. It is obvious that these two nations played a crucial part in worldwide academic exchanges in health economics area. The third and the fourth most collaborative countries are Canada (105 publications) and Australia (100 publications), which shows a degree of cooperation 5 times lower than that of the leading country. The top-10 most collaborative countries continue with the following nations: Netherlands (74 publications), Germany (58), Switzerland (56), Scotland (48), France (46) and Italy (43). Citation burst was identified for 4 countries: the USA 1975–1981, Scotland 1982–2003, Switzerland 1999–2006, and China 2020–2022. Citation burst analysis reveals that China, which stated to published research in health economics in 2006, faces an upward trend in the last two years.

Co-citations analysis

The following step of our current analysis is to find the most frequently cited publications in health economics sector. Co-citation reference analysis help to identification of the most important references in health economics. 16,755 references are linked to our sample. We obtain a co-citation network of 1550 nodes and 7240 links with a density of 0.0060. The network map was obtained without pruning parameter. In Fig.  6 are labelled the papers with more than 5 co-citations. Table 3 lists the top 10 articles in the field of health economics by the number of citations.

Visualization of reference co-citation networks for health economics research. Source: Authors

As we expected, the most influential paper is published by Arrow K.J. in 1963. In his paper, the author investigates and studies the unique distinctions between medical care and other goods and services in normative economics. He focuses on medical-care industry and its efficacy by rethinking the industry from economics perspective. This publication is the basic brick in the conceptualization of health economics. Unfortunately, this part of analysis reveals some basic limitation in bibliometric analysis: incomplete and compromised database because of incorrect data filled by authors. As it can be seen in Fig.  6 , the second most influential paper belongs to an anonymous author who wrote in 1996 a paper about cost effectiveness. A manual search in references database revealed the possibility to correlate the anonymous publications to a book written by Gold M.R., Siegel J.E., Russell L.B. and Weinstein M.C. The authors published in 1996 a book about cost effectiveness in health and medicine and there are several book reviews about it. The third and the fourth most co-cited publications are signed by Drummond M.F. and his co-authors. In fact, it is about a book entitled “Methods for the Economic Evaluation of Health Care Programmes”, first published in 1987 at and then renewed in the following editions: 1997 (2nd), 2005 (3rd) and 2015 (4th). Regardless the edition number, the book is a worldwide bestseller and it very cited in health economics research. It should be mentioned that the 2nd edition of the book appears twice in the database because some authors incorrectly cited Drummond. There are many book reviews for this book because it describes techniques and tools for evaluation of health care programs. It provides syntheses of new and emerging methodologies, and it is less concerned with the theoretical and ethical foundations of the methodologies (Drummond M.F et all, 2005). The book promotes basic health economic concepts and theories.

The citation burst was checked to see the period when a document citation increases sharply in frequency. There are 12 cited papers with citation burst fluctuating from 3.95 for Volpp K.G (2008) and 9.58 for Arrow K.J. (1963). Ten of twelve papers with citation burst are the ones from Table 3 , the most co-cited documents in health economics. The top-10 papers by burst are Arrow K.J. 1963 (period 2012–2018, citation burst 9.58), Drummond M.F. 1997 (2000–2008, 8.76), Anonymous 1996 (1999–2011, 8.86), Drummond M.F 2005 (2008 – 2019, 8.42), Kahneman D. 2011 (2013–2022, 5.03), Williams A. 1985 (1986–1998, 4.44), Lakdawalla (2018–2022, 4.44), Kahneman D. 1979 (2019–2022, 4.38) and Grossman M. 1972 (2016–2019, 4.35).

Two of Kahneman D.’s works stands out. One of them is represented by a book, another worldwide bestseller, entitled “Thinking, Fast and Slow” published in 2011 in London. His psychological book is appreciated because it aids in the public understanding of issues related to engineering, medicine, and behavioural science. The second paper is written by Kahneman D. and Tversky A. in 1979 and presents opponents of the anticipated utility theory as a framework for risky decision-making and introduces an alternative model called prospect theory.

We can find highly cited authors whose work is well known in the health economics research community by using author co-citation networks. CiteSpace configurations are the same. The network of co-cited writers has 1422 nodes, 12,462 linkages, with a density of 0.0123. The node size reflects the number of co-citations by author. In Fig.  7 the nodes with co-citations over 14 are labelled by the corresponding first author. Once again there are incomplete data in the database. We face with an anonymous person as the most cited author in health economics research. This author without name was 300 time co-cited. We manually checked the database to find additional information about this anonymous author. According to the findings we assume it is about Margolis H. who published in 1982 a book about selfishness, altruism, and rationality. Margolis H. is a professor at the University of Chicago and in his book about social choice propose and argue a distinction between self-interest and group-interest for a person, and he also develop an equilibrium model for his theory [ 41 ].

Visualization of authors co-citation networks for health economics research. Source: Authors

Drummond M.F. is on the second position, positioning himself with two publications in the top-10 most co-cited authors. Once again it is about his publication with Mooney G.H. about Essentials in Health Economics which was already mentioned in the paper. Williams A. is the third co-cited author, followed by Culyer A.J and Arrow K.J. It should be noted that World Health Organization’s (WHO) publications are ones of the most co-cited document in health economics research. Unfortunately, it is hard to identify the titles of WHO’s publications from 1993 and 2009 (see Table 4 ) because there is more than one publication per year for this international organization. However, we assume that it is about an anonymous publication focused on tuberculosis as a worldwide problem [ 42 ] (published in 1993) and a publication about health risk at the global level [ 43 ] (published in 2009).

There are no scholars who have a betweenness centrality greater than zero. This indicates that there is no author more influential than other scholars, and no one exert a significant influence on the evolution of health economics research. The evolution of health economics theory was influenced by all the authors discussed in this paper.

In terms of burstiness, there are 35 cited authors with citation burst between 9.26 and 3.90. It means that their papers were intensively cited during a specific period. The top-10 cited authors by bursts is Drummond M. 1988 (bursts of 9.26, period 1995–1999), Maynard A, 1982 (8.60, 1998–2003), WHO 2009 (8.09, 2009–2015), OECD 2013 (7.77, 2013–2022), Williams A. 1982 (7.63, 1986–2003), Johannesson M. 1996 (7.59, 1996–2003), Kahneman D. 2000 (7.55, 2016–2022), WHO 1993 (7.02, 2011–2022), Cutler D.M. 2007 (6.97, 2012–2016) and Donaldson C. 1995 (6.94, 1995–2003). Even if they are not included in the previous ranking, the following cited authors should be mentioned because their burstiness periods exceeds 10 years: Fuchs V.R. 21 years (bursts of 4.54, period 1977–1998), Williams A. 17 years (7.63, 1986–2003), Mooney G. 14 years (5.29, 1995–2009), Dolan P. 14 years (4.84, 2003–2017) and Weinstein M.C. 13 years (4.14, 1999–2011).

The same way as previous maps, the cited journal visualization map for health economics research (Fig.  8 ) was created in CiteSpace, but this network has 1273 nodes (cited journals), 25,008 linkages, and a density of 0.0309. The cited journals with more than 38 citations are labelled in the network.

Journal co-citation network visualization for health economics research. Source: Authors

The top ten journals by citations in health economics are presented in Table 5 . The BMJ – British Medical Journal (381 citations) is the journal published by British Medical Association and the most prominent cited journal in health economics area. It is followed by the New England Journal of Medicine (306 citations) and The Lancet (257 citations). The journal published by American Medicinal Association ranks on the fourth place. A journal that receives a lot of citations and has a high citation burstiness score has garnered the interest of academics recently.

The citation surge affects 70 cited journals. The cited journal with the strongest citation bursts is Plos One (21.79, 2014–2022), which is not the most cited one. It is followed by British Medical Journal (20.22, 1982–2006), Value Health (13.15, 2018–2022), BMJ Open (12.48, 2017–2022), Applied Health Economics and Health Policy (10.38, 2017–2022), BMC Health Services Research (10.16, 2019–2022), Frontiers in Public Health (9.99, 2020–2022), Cost Effectiveness and Resource Allocation (9.66, 1998–2005), JAMA Internal Medicine (9.24, 2019–2022) and BMC Public Health (8.71, 2016–2022). It should be noted that 8 cited journals of the ranking are bursting to the present. British Medical Journal (24 years), American Journal of Psychiatry (15 years), The Journal of Health Services Research and Policy (14 years), The New England Journal of Medicine (13 years) and Medical Care (12 years) are the cited journals with the longest periods of bursting, even if the interest in these journals is currently low. It must be added that four of the most cited journals in health economics research are on a top-10 list of journals with the highest JIF in 2021. All these journals are one of the most influential journals in health research.

Co-occurrence analysis

In this section of the analysis, we can pinpoint the key ideas and areas of interest in health economics research. To discover the primary study subjects in many scientific research domains, keywords are generally regarded as one of the most crucial elements of any research paper [ 44 ]. Co-occurrence analysis is used to identify the conceptual structure of the field. Without any pruning, the network of related keywords is shown in Fig.  9 . The network of co-occurred keyword has 694 nodes (keywords), 2823 links (connections), and a density of 0.0117. One percent of all keywords, those with a frequency greater than or equal to five, are labelled.

Keywords co-occurrence network for health economics research. Source: Authors

Table 6 presents the top 30 keywords which are used and connected in the 1620 analysed papers. “Health economics” and “cost effectiveness” are the most co-occurred items in health economics research, they have been connected for 121 times. “Care” follows them as the second high-count keyword with a frequency of 115. One crucial statistic used in the analysis of the keyword co-occurrence network is centrality. Centrality shows a keyword's strength, influence, or other specific characteristics. In this analysis all the keywords have a null betweenness centrality.

By using bursts detection, we tried to identify research hotspots in health economics. Surprisingly, there are only two keywords with citation bursts during 1975–2022: “behavioural economics” and “economic evaluation”. The keyword with the strongest bursts is “behavioural economics” (5.57) and it caught scholars’ attention between 2019 and 2022. The second keyword by citation bursts is “economic evaluation” (4.62). This item is bursting from 2020 to 2022. It can be observed that both research themes have short periods of bursts, and they continue bursting to present.

CiteSpace allows a cluster analysis of keywords to identify topics that have captured the attention of researchers. By applying clustering tool, the keywords network has been divided in 14 clusters, labelled by keywords. Table 7 presents the top 10 keywords clusters, in descending order of their size, and the most used keywords in the analysed sample of publications. There are 14 clusters with different sizes, from 80 research topics in health economics to 4 research topics. Their Silhouette values varies from 0.757 to 0.995 which means that keywords match well to their own cluster. Figure  10 show that the clustering configuration is appropriate.

Keywords clusters. Source: Authors

The largest cluster (#0) is labelled “Health economics” and has 80 components. It contains publications about health economics, cost effectiveness, quality of life, and management. Cost effectiveness analysis and health technology assessment are subjects in the second largest cluster (#1). It is labelled “Value framework” and has 78 topics. The third cluster (#2) “Economic evaluation” contains 75 topics and the most important are care, economic evaluation, outcome, and benefits. Other research topics refer to behavioural economics, demand, cost, quality of life, risk, cancer, public heath, financial incentives, therapy, etc.

The evolution over time of the keywords can be seen in Fig.  11 , structured by cluster. CiteSpace restricts the time pane analyses to the period 1990 – 2022. Figures  11 and 12 present how interest of researchers in health economics has evolved over time. In Fig.  12 are labelled the keywords with a frequency larger than 10. In the 1990s the hot topics of research in health economics were “care”, “impact”, “health economics”, “cost”, “cost effectiveness”, “quality of life”, “outcome”, “economic evaluation”. The most debated research topics in the 2000s were “children”, “air pollution”, “patient”, “management”, “people”, “public health”, “choice”, “therapy and “risk”. In the 2010s focus is on “behavioural economics”, “population”, “obesity”, “uncertainty”, “ technology”, “health policy”, “health system”. How future research in health economics looks? It cannot be estimated with certainty, but some directions are drawn as follows: “inequality”, “care expenditure”, “health technologies”, “analysis plan”, “adaptative design”, “transparency”, “biodiversity”. These topics may shape the future literature in health economics.

Timeline view of keywords clusters in health economics between 1990 and 2022. Source: Authors

Time zone view of keywords clusters in health economics between 1990 and 2022. Source: Authors

The performed literature analysis enables us to respond to the research queries that were addressed in the paper's introduction, as follows:

How scientific production has evolved in health economics?

It can be observed a general upward trend of health economics publications, but with numerous upward and downward fluctuations, generating sinusoidal cycles with an average duration of 3–4 years. The period 1975 – 1986 is characterized by a very low number of publications. The next two decades (1987 – 2006) are characterized by a slightly increasing trend in the number of publications, with an annual average of approximately 23 publications on health economics. The following period, 2007 – 2022 is characterized by an upward evolution of the number of health economics publications, 1068 publications with an annual average of 67 articles. The evolution of the citations’ number indicates the growing interest of specialists in researching the field, especially after 2000 when a constant and galloping annual increase in citations begins. The last 5 years show a very high interest of researchers and academics in health economics research, which is justified by the existence of worldwide Covid pandemic period.

Who are the most important authors and publications in health economics?

In our study, 4096 different authors were identified, and they individually published between one and 16 papers. Among the most important authors in health economics are Drummond M.F., Jonsson B., Coast J., Donaldson C. and Edwards R.T. Regarding the publication’s titles, 847 distinct journals published all 1620 documents related to health economics. Value Health, Health Economics, British Medical Journal, Pharmacoeconomics and Health Policy are among journals with high interest in health economics publications.

What are the geographical and institutional hubs of knowledge production in health economics?

The analysed publications involved the work of authors from 82 countries. The states with significant contributions in the field of health economics are the USA, England, Canada, Australia, and Netherlands. From the point of view of affiliation, the authors belong to 1723 institutions. The institutions with a high number of publications about health economics are University of London, University of California System, University of York, Harvard University and University of Birmingham.

What kind of collaboration between authors, organizations, and nations are there in the field of health economics research?

There are not strong collaboration relationships between authors. They are divided in small research groups and cooperation for research in health economics is insignificant. The most collaborative authors are Drummond M., Mooney G., Trosch R., Marchese D., and Fuchs V. There are two research teams created around Drummond M. and Mooney G., on the one hand, and around Trosch R. and Marchese D., on the other hand. Cooperation among institutions is depending on cooperation among authors. It is understood that poor collaboration at the individual level is followed by an identical one at the organizational level. The most collaborative institutions in health economics area are University of York, University of Oxford, University of Pennsylvania, University of Washington, and University of Birmingham. Regarding collaboration between countries, the USA and England played a key role in worldwide academic exchanges in health economics area, followed by Canada, Australia, and Netherlands.

Which are the most cited authors and the most cited papers, and which are the most attractive journals for publishing research results in health economics?

The most influential paper is published by Arrow K.J. in 1963, entitled “Uncertainty and the Welfare Economics of Medical Care”. The second most influential paper belongs to an anonymous author who wrote in 1996 a paper about cost effectiveness. We assume that is a book written by Gold M.R., Siegel J.E., Russell L.B. and Weinstein M.C., entitled “Cost-Effectiveness in Health and Medicine”. The third and the fourth most cited publications are signed by Drummond M.F. and his co-authors. In fact, it is about a book entitled “Methods for the Economic Evaluation of Health Care Programmes”, first published in 1987 at and then renewed in several editions. Another influential book was written by Kahneman D., entitled “Thinking, Fast and Slow” and published in 2011. The most cited author is Margolis H., who published in 1982 a book about “Selfishness, Altruism, and Rationality”. Drummond M.F. is on the second position with the publications about “Essentials in Health Economics”. Williams A. is the third cited author, followed by Culyer A.J and Arrow K.J. It should be noted that World Health Organization’s (WHO) publications are ones of the most cited document in health economics research. The most cited journals in health economics are The BMJ – British Medical Journal, The New England Journal of Medicine, The Lancet, Journal of American Medicinal Association and Health Economics. Beside them, other very influential journals are Plos One, Value Health, BMJ Open, Applied Health Economics and Health Policy and BMC Health Services Research.

What are the most debated conceptual approaches in health economics?

“Health economics”, “cost effectiveness” and “care” are the most debated concepts in health economics. But the current research hotspots in health economics are “behavioural economics” and “economic evaluation”.

Discussions and conclusions

The current bibliographic analysis was done for a specialized literature: health economics. This analysis contributes to the evaluation of the progress of the global knowledge in health economics and to the evaluation of the interest in health economics research. Moreover, the research allows the identification of the authors who contributed to the theoretical conceptualization of health economics, but also the identification of the most cited works in the field. A bibliometric analysis of the health economics research topic was produced, based on 1620 papers that were published between 1975 and 2021 and indexed in WoS. According to the tables and figures above, we have identified the important authors, publications, nations, organizations, keywords, and references.

By giving information on the current state of the art and identifying trends and research possibilities through the selection and analysis of the most pertinent publications published in the subject of health economics, the current study completes the body of existing research.

Through an extensive field mapping, the study increases the added value for the study of health economics theory. The development patterns of health economics are described by identifying trends in research production in that field and the most productive nations. The identification of top contributors’ points to possible collaborators (universities and researchers) for additional research projects. Finding the most appealing source names reveals publishing prospects for health economics-related articles. Leading thematic areas and developing research areas can be found to help academics identify research gaps in health economics.

Limitations and future research directions

Even though the bibliometric analysis and mapping visualization on articles relevant to health economics in the current research have produced numerous fascinating results, this methodology has several drawbacks. These limitations are due to the bibliometric analysis and quality of database. A quantitative analysis reduces the influence of subjective judgments. In several parts of the analysis, we were forces to use manual search because of inadequate or incomplete data. Maybe, manual analysis is required to learn additional specifics about different aspects of health economics theory by using a systematic review analysis.

The following limitations of the current study should be considered. First, the search strategy leads to a lost in publications which do not contain the query word in the publication title. Therefore, the main findings should be interpreted in accordance with the selection strategy used in this paper. The dataset is downloaded only from WoS, maybe multi-source searching is more convincing. Publications in other languages were not analysed. For some publications the name of author was missing. Some journals change their title in time, and they appear twice as being different journals. In this analysis it was used an inhomogeneous sample due to the type of publications.

Therefore, these restrictions remain issues that need to be resolved in additional research. To sum up, our analysis cannot cover every crucial publication concerning health economics, but we believe that the results allow us to have reliable insight into the knowledge domain. This study could be carried out in the future utilizing new search criteria, time periods, or bibliometric analytic parameters.

Availability of data and materials

The data can be extracted from Web of Science. All data are available upon application.

Abbreviations

European Union

Gross Domestic Product

Journal Impact Factor

Organisation for Economic Co-operation and Development

Science Citation Index Expanded

Social Science Citation Index

The United Kingdom

The United States of America

World Health Organization

Web of Science

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Project financed by Lucian Blaga University of Sibiu through the research grant LBUS-IRG-2022-08.

This study was fund by Lucian Blaga University of Sibiu through the research grant LBUS-IRG-2022–08.

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Barbu, L. Global trends in the scientific research of the health economics: a bibliometric analysis from 1975 to 2022. Health Econ Rev 13 , 31 (2023). https://doi.org/10.1186/s13561-023-00446-7

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Quick Careers Facts for the Department of Health Policy

Median salary of our PG students 15 months after graduating: £38,000          

Top 5 sectors our students work in:

• Health and Social Care  
• Education, Teaching and Research            
• FMCG, Manufacturing and Retail              
• Government, Public Sector and Policy   
• Consultancy

The data was collected as part of the Graduate Outcomes survey, which is administered by the Higher Education Statistics Agency (HESA). Graduates from 2020-21 were the fourth group to be asked to respond to Graduate Outcomes. Median salaries are calculated for respondents who are paid in UK pounds sterling and who were working in full-time employment.

Recent doctoral graduates who were supervised by staff in the Department of Health Policy went on to be employed in international organisations such as the WHO, IMF, World Bank, European Union, OECD, African Development Bank, Asian Development Bank, and the United Nations. Some joined national and regional Ministries of Health, the English NHS - and others went on to work with consultancy firms, pharmaceutical companies, and think tanks such as The King's Fund and the Health Foundation.

Further information on graduate destinations for this programme

Support for your career

Alongside leading organisations' career presentations and events, LSE Careers also offers  resources and bespoke advice to assist PhD students with their career progression within or outside of academia. 

If you have any questions about the programme, please contact:  [email protected] .

Find out more about LSE

Discover more about being an LSE student - meet us in a city near you, visit our campus or experience LSE from home. 

Experience LSE from home

Webinars, videos, student blogs and student video diaries will help you gain an insight into what it's like to study at LSE for those that aren't able to make it to our campus.  Experience LSE from home . 

Come on a guided campus tour, attend an undergraduate open day, drop into our office or go on a self-guided tour.  Find out about opportunities to visit LSE . 

LSE visits you

Student Marketing, Recruitment and Study Abroad travels throughout the UK and around the world to meet with prospective students. We visit schools, attend education fairs and also hold Destination LSE events: pre-departure events for offer holders.  Find details on LSE's upcoming visits . 

How to apply

Register your interest

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Mphil/phd social policy.

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Are you a UK or International Student?

Make a difference to the development of healthcare interventions, key course details.

Course Overview

Start dates: 1st October, 1st January, 1st April, 1st July.

Health economics is at the core of innovation, health technology assessment, prioritisation and programme budgeting within the UK NHS and worldwide. A PhD or MPhil in Health Economics at the Swansea Centre for Health Economics (SCHE) offers an outstanding opportunity to make an original contribution to the development and application of health economics and outcome research to real-life issues in healthcare delivery and policy.

Offering flexibility through a wholly research-based mode of study, our MSc by Research in Health Economics course is perfect for those looking to balance work, life and study commitments

You will develop skills in core health economic methods and analysis to design and deliver your own research project, supported by a tailor-made programme of supervision and training. This can include developing knowledge and skills in aspects of the use of epidemiology, quantitative research and routine data analysis as well as applying health economic analysis as part of health technology assessment, public health and evaluation of health and social care interventions and services.  We also offer particular expertise in the area of prioritisation and in the design, use and interpretation of patient-reported outcomes.

As a student at the School of Health and Social Care, you will benefit from a dynamic and supportive research environment with many opportunities to make connections across disciplines and develop links with organisations and policymakers both in the UK and abroad. As such, you can be confident that your research will inform and be informed by the wider health and social care environment.

According to the most recent Research Excellence Framework in 2014-2021, over 75% of the research carried out at the college was of international or world-leading quality.

You will be joining a university that was named ‘University of the Year’ and ‘Postgraduate’ runner up in the What Uni Student Choice Awards 2019.

Entry Requirements

Qualifications MPhil:  Applicants for MPhil must normally hold an undergraduate degree at 2.1 level (or Non-UK equivalent as defined by Swansea University). See -  Country-specific Information for European Applicants 2019  and  Country-specific Information for International Applicants 2019 .

PhD : Applicants for PhD must normally hold an undergraduate degree at 2.1 level and a master’s degree. Alternatively, applicants with a UK first class honours degree (or Non-UK equivalent as defined by Swansea University) not holding a master’s degree, will be considered on an individual basis.  See -  Country-specific Information for European Applicants 2019  and  Country-specific Information for International Applicants 2019 . 

English Language IELTS 6.5 Overall (with no individual component below 6.5) or Swansea University recognised equivalent.  Full details of our English Language policy, including certificate time validity, can be found here.

As well as academic qualifications, Admissions decisions may be based on other factors, including (but not limited to): the standard of the research synopsis/proposal, performance at interview, intensity of competition for limited places, and relevant professional experience.

Reference Requirement

As standard, two references are required before we can progress applications to the College/School research programme Admissions Tutor for consideration.

Applications received without two references attached are placed on hold, pending receipt of the outstanding reference(s). Please note that any protracted delay in receiving the outstanding reference(s) may result in the need to defer your application to a later potential start point/entry month, than what you initially listed as your preferred start option.

You may wish to consider contacting your referee(s) to assist in the process of obtaining the outstanding reference(s) or alternatively, hold submission of application until references are sourced. Please note that it is not the responsibility of the University Admissions Office to obtain missing reference(s) after our initial email is sent to your nominated referee(s), requesting a reference(s) on your behalf.

The reference can take the form of a letter on official headed paper, or via the University’s standard reference form. Click this link to download the university reference form .

Alternatively, referees can email a reference from their employment email account, please note that references received via private email accounts, (i.e. Hotmail, Yahoo, Gmail) cannot be accepted.

References can be submitted to [email protected] .

How you are Supervised

Current and recent theses in health economics, supervised by our experienced team at Swansea Centre for Health Economics, include:

• An investigation of trends in opioid prescribing and associated resource utilisation in Wales using a large routine dataset
• Barriers and facilitators of cancer rehabilitation services and support in Wales with focus on patient experience and cost-consequences
• The extent to which cell salvage can support patient blood management
• Healthcare priority setting and disinvestment in the context of prudent healthcare
• Divergence from the optimal care pathway for patients with chronic obstructive pulmonary disease
• Value based health care: Patient and Citizen values and how they relate to the evaluation of technologies to educate people with cancer
• Time driven activity based costing: testing and developing a financial approach for practical application in the NHS
• Evaluation of the effectiveness and cost-effectiveness of a clinical pharmacist-led intervention for secondary prevention of cardiovascular diseases in Saudi Arabia

Academic staff supervising theses in these areas:

• Dr Pippa Anderson
• Professor Deborah Fitzsimmons
• Dr Mari Jones 
• Professor Ceri Phillips 
• Dr Bernadette Sewell

Welsh Provision

Tuition fees, ph.d. 3 year full time.

Ph.D. 6 Year Part Time

MSc by Research 1 Year Full Time

MSc by Research 2 Year Part Time

M.Phil 2 Year Full Time

M.phil 4 year part time.

Tuition fees for years of study after your first year are subject to an increase of 3%.

You can find further information of your fee costs on our tuition fees page .

You may be eligible for funding to help support your study. To find out about scholarships, bursaries and other funding opportunities that are available please visit the University's scholarships and bursaries page .

International students and part-time study: It may be possible for some students to study part-time under the Student Visa route. However, this is dependent on factors relating to the course and your individual situation. It may also be possible to study with us if you are already in the UK under a different visa category (e.g. Tier 1 or 2, PBS Dependant, ILR etc.). Please visit the University information on Visas and Immigration for further guidance and support.

Current students: You can find further information of your fee costs on our tuition fees page .

Funding and Scholarships

You may be eligible for funding to help support your study.

Government funding is now available for Welsh, English and EU students starting eligible postgraduate research programmes at Swansea University. To find out more, please visit our postgraduate loans page.

To find out about scholarships, bursaries and other funding opportunities that are available please visit the University's scholarships and bursaries page.

Academi Hywel Teifi at Swansea University and the Coleg Cymraeg Cenedlaethol offer a number of generous scholarships and bursaries for students who wish to study through the medium of Welsh or bilingually. For further information about the opportunities available to you, visit the Academi Hywel Teifi Scholarships and Bursaries page.

Additional Costs

Access to your own digital device/the appropriate IT kit will be essential during your time studying at Swansea University. Access to wifi in your accommodation will also be essential to allow you to fully engage with your programme. See our dedicated webpages for further guidance on suitable devices to purchase, and for a full guide on getting your device set up .

You may face additional costs while at university, including (but not limited to):

• Travel to and from campus
• Printing, photocopying, binding, stationery and equipment costs (e.g. USB sticks)
• Purchase of books or texts
• Gowns for graduation ceremonies

How to Apply

Details of the application process for research degrees are available  here , and you can apply online and track your application status at  www.swansea.ac.uk/applyonline .  As part of your application you should include a research proposal outlining your proposed topic of study.  Guidance on writing a research proposal is also  available .

You can expect to be interviewed following your application to discuss your topic of research and to demonstrate the necessary level of commitment to your studies and training.

It is advisable that you contact us at [email protected]  before submitting your application. This will ensure we can identify appropriate supervisors, and work with you to refine your proposal.

If you're an international student, find out more about applying for this course at our  international student web pages 

Suggested Application Timings

In order to allow sufficient time for consideration of your application by an academic, for potential offer conditions to be met and travel / relocation, we recommend that applications are made before the dates outlined below. Please note that applications can still be submitted outside of the suggested dates below but there is the potential that your application/potential offer may need to be moved to the next appropriate intake window.

October Enrolment

UK Applicants – 15th August

EU/International applicants – 15th July

January Enrolment

UK applicants – 15th November

EU/International applicants – 15th October

April Enrolment

UK applicants – 15th February

EU/International applicants – 15th January

July Enrolment

UK applicants – 15th May

EU/International applicants – 15th April

EU students - visa and immigration information is available and will be regularly updated on our information for EU students page.

The Swansea Centre for Health Economics (SCHE), as part of the School of Health and Social Care, offers extensive experience and outstanding support to successfully complete your research project. This includes established links to industry and access to many different facilities, expertise and further equipment at organisations that we work closely with, such as the NHS, Health Boards and Trusts, Social Care or Health Technology Assessment agencies (e.g. the All Wales Medicines strategy Group and Health Technology Wales). 

Research Networks

As well as being immersed in the vibrant research community of the school and its research groups, you will also be able to access wider support and advice through the research networks our staff are involved in. SCHE is part of the  Welsh Health Economics Support Service which provides a community of health economic researchers across Wales. Furthermore, as a research student you will be part of the Welsh Health Economics Group which meets during a two-day conference on an annual basis.

This provides a fantastic opportunity to network with other students, researchers and academics working in the discipline and to gain experience of presenting your work.  You can also engage in the wider health and social care research community with close links to other research centres and units such as the Centre for Ageing and Dementia Research (CADR), Wales Centre for Primary and Emergency Care Research (PRIME), Diabetes Research Unit Cymru and Clinical Trials Units based at Cardiff and Swansea University.  We work closely with other academic groups across the UK on a variety of projects and are members of the Asthma UK Centre for Applied Research.

Who should consider a PhD, MPhil or MSc by Research in Health Economics?

Consider a PhD, MPhil or MSc by Research in Health Economics if you:

• Have a keen interest in economic principles, health policy, health technology assessment and priority setting
• Wish to use health economic methods to address original questions which impact on delivery of healthcare and policy and have the potential to benefit the healthcare system and its patients
• Aspire to develop knowledge and skills in this specific area of social science and health services research
• Want to develop in-depth and advanced skills in methodology and analysis to address real-world questions
• Are not afraid of numbers, large datasets or statistics
• Wish to be a part of a thriving, innovative and friendly research community
• Aim to be well prepared for a future career in research, academia and the private sector

Research Student Testimonial

Abdulaziz Altowaijri completed his research into the benefits of clinical pharmacist services involved in the care of patients with cardiovascular disease in an inpatient setting, supervised by Prof. Ceri Phillips and Prof. Deb Fitzsimmons.

Aziz investigated the efficacy and cost-effectiveness of this service by using health technology assessment methods. When interviewed about his PhD experience, he told us:

“I really enjoyed the whole process. Of course, I also faced difficulties, especially during data collection and write-up.  However, with the invaluable and friendly support of my supervisory team, I managed to complete all my tasks within time and was well-prepared for my viva examination.

My training and experiences during my PhD studies prepared me well for my future research career and provided me with expertise on how to conduct robust and well-designed research and health economic evaluations. Furthermore, by studying at PhD level I broadened my horizon, built up my skills and confidence and made friends for life.”

PhD Programme Specification

This Programme Specification refers to the current academic year and provides indicative content for information. The University will seek to deliver each course in accordance with the descriptions set out in the relevant course web pages at the time of application. However, there may be situations in which it is desirable or necessary for the University to make changes in course provision , either before or after enrolment.

Programme Summary 

This PhD in Health Economics at Swansea will enable you to undertake a substantial project led by your own interests. It is a highly respected qualification which can present a career in academia or a wider scope for employment in fields such as education, government or the private sector. A thesis of 100,000 words will be submitted for assessment demonstrating original research with a substantive contribution to the subject area. The PhD is examined following an oral examination of the thesis (a viva voce examination or viva voce). You will acquire research skills for high-level work and skills and training programmes are available on campus for further support. There will be an opportunity to deliver presentations to research students and staff at departmental seminars and conferences. There may also be opportunities to develop your teaching skills through undergraduate tutorials, demonstrations and seminars.

Programme Aims

This PhD programme will provide doctoral researchers with:

• The opportunity to conduct high quality postgraduate research in a world leading research environment.
• Key skills needed to undertake advanced academic and non-academic research including qualitative and quantitative data analysis.
• Advanced critical thinking, intellectual curiosity and independent judgement.

Programme Structure

The programme comprises three key elements:

• Entry and confirmation of candidature
• Main body of research
• Thesis and viva voce

The programme comprises of the undertaking of an original research project of 3 years duration full time (6 years duration part time). Doctoral researchers may pursue the programme either full time or part time by pursuing research at the University at an external place of employment or with/at a University approved partner.

Doctoral researchers for the PhD in Health Economics are examined in two parts.

The first part is a thesis which is an original body of work representing the methods and results of the research project. The maximum word limit is 100,000 for the main text. The word limit does not include appendices (if any), essential footnotes, introductory parts and statements or the bibliography and index.

The second part is an oral examination (viva voce).

Doctoral Researcher Supervision and Support

Doctoral researchers will be supervised by a supervisory team. Where appropriate, staff from Colleges/Schools other than the ‘home’ College/School (other Colleges/Schools) within the University will contribute to cognate research areas. There may also be supervisors from an industrial partner.

The Primary/First Supervisor will normally be the main contact throughout the doctoral research journey and will have overall responsibility for academic supervision. The academic input of the Secondary Supervisor will vary from case to case. The principal role of the Secondary Supervisor is often as a first port of call if the Primary/First Supervisor becomes unavailable. The supervisory team may also include a supervisor from industry or a specific area of professional practice to support the research. External supervisors may also be drawn from other Universities.

The primary supervisor will provide pastoral support. If necessary the primary supervisor will refer the  doctoral researcher to other sources of support (e.g. Wellbeing, Disability, Money Advice, IT, Library, Students’ Union, Academic Services, Student Support Services, Careers Centre). 

Programme Learning Outcomes

Upon successful completion of this programme,  doctoral researchers should be able to:

Knowledge & Understanding

• Demonstrate the systematic acquisition and understanding of a substantial body of knowledge which is at the forefront of research through the development of a written thesis.
• Create, interpret, analyse and develop new knowledge through original research or other advanced scholarship. 
• Disseminate new knowledge gained through original research or other advanced scholarship via high quality peer reviewed publications within the discipline.
• Apply research skills and subject theory to the practice of research.
• Apply process and standards of a range of the methodologies through which research is conducted and knowledge acquired and revised. 

Attitudes and values

• Conceptualise, design and implement a project aimed at the generation of new knowledge or applications within Health Economics.
• Make informed judgements on complex issues in the field of Health Economics, often in the absence of complete data and defend those judgements to an appropriate audience.
• Apply sound ethical principles to research, with due regard for the integrity of persons and in accordance with professional codes of conduct.
• Demonstrate self-awareness of individual and cultural diversity, and the reciprocal impact in social interaction between self and others when conducting research involving people.

Research Skills

• Respond appropriately to unforeseen problems in project design by making suitable amendments.
• Communicate complex research findings clearly, effectively and in an engaging manner to both specialist (including the academic community), and non-specialist audiences using a variety of appropriate media and events, including conference presentations, seminars and workshops.
• Correctly select, interpret and apply relevant techniques for research and advanced academic enquiry.
• Develop the networks and foundations for on-going research and development within the discipline.
• Implement  advanced research skills to a substantial degree of independence.
• Locate information and apply it to research practice.

Skills and Competencies

• Display the qualities and transferable skills necessary for employment, including the exercise of personal responsibility and largely autonomous initiative in complex and unpredictable situations, in professional or equivalent environments.

Progression Monitoring

Progress will be monitored in accordance with Swansea University regulations. During the course of the programme, the Doctoral researcher is expected to meet regularly with their supervisors, and at most meetings it is likely that the doctoral researcher’s progress will be monitored in an informal manner in addition to attendance checks. Details of the meetings should ideally be recorded on the on-line system. A minimum of four formal supervision meetings is required each year, two of which will be reported to the Postgraduate Progression and Awards Board. During these supervisory meetings the doctoral researcher’s progress is discussed and formally recorded on the on-line system.  

Learning Development  

The University offers training and development for Doctoral Researchers and supervisors ( https://www.swansea.ac.uk/research/undertake-research-with-us/postgraduate-research/training-and-skills-development-programme/ ).

Swansea University’s Postgraduate Research Training Framework is structured into sections, to enable doctoral researchers to navigate and determine appropriate courses aligned to both their interest and their candidature stage. 

There is a training framework including for example areas of Managing Information and Data, Presentation and Public Engagement, Leadership and working with others, Safety Integrity and Ethics, Impact and Commercialisation and Teaching and Demonstrating. There is also range of support in areas such as training needs, literature searching, conducting research, writing up research, teaching, applying for grants and awards, communicating research and future careers.

A range of research seminars and skills development sessions are provided within the School of Health and Social Care and across the University. These are scheduled to keep the  doctoral researcher in touch with a broader range of material than their own research topic, to stimulate ideas in discussion with others, and to give them opportunities to such as defending their own thesis orally, and to identify potential criticisms. Additionally, the School of Health and Social Care is developing a research culture that aligns with the University vision and will link with key initiatives delivered under the auspices of the University’s Academies, for example embedding the HEA fellowship for postgraduate research students.

Research Environment

Swansea University’s research environment combines innovation and excellent facilities to provide a home for multidisciplinary research to flourish. Our research environment encompasses all aspects of the research lifecycle, with internal grants and support for external funding and enabling impact/effect that research has beyond academia. 

Swansea University is very proud of our reputation for excellent research, and for the calibre, dedication, professionalism, collaboration and engagement of our research community. We understand that integrity must be an essential characteristic of all aspects of research, and that as a University entrusted with undertaking research we must clearly and consistently demonstrate that the confidence placed in our research community is rightly deserved. The University therefore ensures that everyone engaged in research is trained to the very highest standards of research integrity and conducts themselves and their research in a way that respects the dignity, rights, and welfare of participants, and minimises risks to participants, researchers, third parties, and the University itself. 

In the School of Health and Social Care we are strongly focused on the translation of our research into real-life benefits for users, carers and professionals across the range of health and social care services. In doing so our staffs has long established links with a range of international networks and similar university departments in Europe and around the world, and are committed to building productive relationships with front-line policymakers and practitioners. Some senior researchers have also been embedded within the NHS to ensure healthcare and service provision is developed and informed by high quality robust research.                                                                                                               

Alongside this we play an integral role in the Welsh Government’s research infrastructure, through the Centre for Ageing & Dementia Research, Wales School for Social Care Research and the Welsh Health Economic Support Service, increasing the volume of research taking place within Wales. While some of our PhD programmes form part of the ESRC Doctoral Training Centre for Wales, a pan-Wales collaboration to train top-level social scientists. Our funding also comes from a wide range of prestigious funders such as the Research Councils, European research programmes, Government, Ministry of Defence, professional bodies, private sector and charitable organisations, with the school securing £7.37m of funding across the last three years.

Supporting our staff and students in their research is a range of facilities including  our Health and Wellbeing Academy, which provides healthcare services to the local community, a range of clinical and audiology suites and state-of-the-art research facilities. These include a high density EEG suite, a fully-fitted sleep laboratory, a social observation suite, eye-tracking, psychophysiological, tDCS and conditioning labs, a lifespan lab and baby room, and over 20 all-purpose research rooms.

Career Opportunities

Having a PhD demonstrates that graduates can work effectively in a team, formulate, explore and communicate complex ideas and manage advanced tasks. Jobs in academia (eg postdoctoral research, lecturing), education, government, management, the public or private sector are possible. Examples include administrators, counsellors, marketing specialists, and researchers.

The Postgraduate Research Office Skills Development Team offer support and a training framework for example in creating a researcher profile based upon publications and setting up your own business. The Swansea Employability Academy assists students in future career opportunities, improving CVs, job applications and interview skills.

MPhil Programme Specification

Programme Summary

This MPhil in Health Economics at Swansea will enable you to undertake a substantial project led by your own interests. It is a highly respected qualification which can present a career in academia or a wider scope for employment in fields such as education, government or the private sector. A thesis of 60,000 words will be submitted for assessment demonstrating original research with a substantive contribution to the subject area. The Masters is examined following an oral examination of the thesis (a viva voce examination or viva). You will acquire research skills for high-level work and skills and training programmes are available on campus for further support. There will be an opportunity to deliver presentations to research students and staff at departmental seminars and conferences. 

This Masters programme will provide students with:

• Thesis and viva voce examination

The programme comprises of the undertaking of an original research project of 2 years duration full time (4 years duration part time). Students may pursue the programme either full time or part time by pursuing research at the University at an external place of employment or with/at a University approved partner.

Students for the Masters in Health Economics are examined in two parts.

The first part is a thesis which is an original body of work representing the methods and results of the research project. The maximum word limit is 60,000 for the main text. The word limit does not include appendices (if any), essential footnotes, introductory parts and statements or the bibliography and index.

The second part is an oral examination ( viva voce ).

Supervision and Support 

Students will be supervised by a supervisory team. Where appropriate, staff from Colleges/Schools other than the ‘home’ College/School (other Colleges/Schools) within the University will contribute to cognate research areas. There may also be supervisors from an industrial partner.

The Primary/First Supervisor will normally be the main contact throughout the student journey and will have overall responsibility for academic supervision. The academic input of the Secondary Supervisor will vary from case to case. The principal role of the Secondary Supervisor is often as a first port of call if the Primary/First Supervisor becomes unavailable. The supervisory team may also include a supervisor from industry or a specific area of professional practice to support the research. External supervisors may also be drawn from other Universities.

The primary supervisor will provide pastoral support. If necessary the primary supervisor will refer the student to other sources of support (e.g. Wellbeing, Disability, Money Advice, IT, Library, Students’ Union, Academic Services, Student Support Services, Careers Centre).

Upon successful completion of this programme, doctoral researchers should be able to:

• Demonstrate the systematic acquisition and understanding of a substantial body of knowledge through the development of a written thesis.
• Create, interpret, analyse and develop new knowledge through original research or other advanced scholarship.  
• Apply process and standards of a range of the methodologies through which research is conducted and knowledge acquired and revised.
• Make informed judgements on complex issues in the field of Health Economics often in the absence of complete data and defend those judgements to an appropriate audience. 
• Communicate complex research findings clearly, effectively and in an engaging manner to both specialist (including the academic community), and non-specialist audiences using a variety of appropriate media.
• Correctly select, interpret and apply relevant techniques for research and academic enquiry.
• Develop the foundations for on-going research and development within the discipline.
• Implement independent research skills.
• Display the qualities and transferable skills necessary for employment, including the exercise of personal responsibility and initiative in complex situations.

Progress will be monitored in accordance with Swansea University regulations. During the course of the programme, the student is expected to meet regularly with their supervisors, and at most meetings it is likely that the student’s progress will be monitored in an informal manner in addition to attendance checks. Details of the meetings should ideally be recorded on the on-line system. A minimum of four formal supervision meetings is required each year, two of which will be reported to the Postgraduate Progression and Awards Board. During these supervisory meetings the student’s progress is discussed and formally recorded on the on-line system. 

Swansea University’s Postgraduate Research Training Framework is structured into sections, to enable students to navigate and determine appropriate courses aligned to both their interest and their candidature stage. 

A range of research seminars and skills development sessions are provided within the School of Health and Social Care and across the University. These are scheduled to keep the student in touch with a broader range of material than their own research topic, to stimulate ideas in discussion with others, and to give them opportunities to such as defending their own thesis orally, and to identify potential criticisms. Additionally, the School of Health and Social Care is developing a research culture that will align with the University vision and will link with key initiatives delivered under the auspices of the University’s Academies, for example embedding the HEA fellowship for postgraduate research students

Research Environment  

Swansea University’s Research Environment combines innovation and excellent facilities to provide a home for multidisciplinary research to flourish. Our research environment encompasses all aspects of the research lifecycle, with internal grants and support for external funding and enabling impact/effect that research has beyond academia. 

Swansea University is very proud of our reputation for excellent research, and for the calibre, dedication, professionalism, collaboration and engagement of our research community. We understand that integrity must be an essential characteristic of all aspects of research, and that as a University entrusted with undertaking research we must clearly and consistently demonstrate that the confidence placed in our research community is rightly deserved. The University therefore ensures that everyone engaged in research is trained to the very highest standards of research integrity and conducts themselves and their research in a way that respects the dignity, rights, and welfare of participants, and minimises risks to participants, researchers, third parties, and the University itself.

School of Health and Social Care 

In the School of Health and Social Care we are strongly focused on the translation of our research into real-life benefits for users, carers and professionals across the range of health and social care services. In doing so our staff have long established links with a range of international networks and similar university departments in Europe and around the world, and are committed to building productive relationships with front-line policymakers and practitioners. Some senior researchers have also been embedded within the NHS to ensure healthcare and service provision is developed and informed by high quality robust research.                                                                                                         

Alongside this we play an integral role in the Welsh Government’s research infrastructure, through the Centre for Ageing & Dementia Research, Wales School for Social Care Research and the Welsh Health Economic Support Service, increasing the volume of research taking place within Wales. While some of our PhD programmes form part of the ESRC Doctoral Training Centre for Wales, a pan-Wales collaboration to train top-level social scientists. Our funding also comes from a wide range of prestigious funders such as the Research Councils, European research programmes, Government, Ministry of Defence, professional bodies, private sector and charitable organisations, with the school securing £7.37m of funding across the last three years.

Having a Master of Philosophy degree shows that you can communicate your ideas and manage tasks. Jobs in academia, education, government, management, the public or private sector are possible. 

MSc by Research Programme Specification

This MSc by Research in Health Economics at Swansea will enable you to undertake a research project led by your own interests. It is a highly respected qualification which can enable a future career in academia or a wider scope for employment in fields such as education, government or the private sector. A thesis of 40,000 words will be submitted for assessment demonstrating original research with a substantive contribution to the subject area. The Masters is examined following an oral examination of the thesis (a viva voce examination or viva). You will acquire research skills for high-level work and skills and training programmes are available on campus for further support. 

• Key skills needed to undertake advanced academic and non-academic research including qualitative and quantitative data analysis

The programme comprises of the undertaking of an original research project of 1 year duration full time (2 years duration part time). 

Students for the Masters by Research in Health Economics are examined in two parts.

The first part is a thesis which is an original body of work representing the methods and results of the research project. The word limit is 40,000 for the main text. The word limit does not include appendices (if any), essential footnotes, introductory parts and statements or the bibliography and index.

• Critically reflect on the existing knowledge base, current problems and/or new insights, in the field of Health Economics.
• Demonstrate originality in the application of knowledge, together with a practical understanding of how established techniques of research and enquiry are used to create and interpret knowledge in the discipline.
• Apply research skills, methodologies and subject theory to the practice of research.
• Create, interpret and analyse knowledge in the specific field of study through original research.  
• Undertake research tasks and make informed judgements with minimum guidance. 
• Demonstrate self-direction and originality in tackling and solving problems, and act autonomously in planning and implementing tasks at a professional or equivalent level.
• Approach and resolve complex issues both systematically and creatively, make sound judgements in the absence of complete data, and communicate their conclusions clearly to specialist and non-specialist audiences.
• Evaluate and apply relevant techniques for research in Health Economics.
• Apply research methodologies and develop critiques of them and, where appropriate, propose new hypotheses.
• Work in groups, presenting conclusions and reflecting difference of opinion.
• Design and implement a research project.
• The exercise of initiative and personal responsibility.
• Decision-making in complex and unpredictable situations.
• The independent learning ability required for continuing professional development.

A range of research seminars and skills development sessions are provided within the school and across the University. These are scheduled to keep the student in touch with a broader range of material than their own research topic, to stimulate ideas in discussion with others, and to give them opportunities to such as defending their own thesis orally, and to identify potential criticisms. Additionally, the College is developing a research culture that will align with the University vision and will link with key initiatives delivered under the auspices of the University’s Academies.

In the School of Health and Social Care we are strongly focused on the translation of our research into real-life benefits for users, carers and professionals across the range of health and social care services. In doing so our staff have long established links with a range of international networks and similar university departments in Europe and around the world, and are committed to building productive relationships with front-line policymakers and practitioners. Some senior researchers have also been embedded within the NHS to ensure healthcare and service provision is developed and informed by high quality robust research.                                                                                                                 

Supporting our staff and students in their research is a range of facilities including our Health and Wellbeing Academy, which provides healthcare services to the local community, a range of clinical and audiology suites and state-of-the-art research facilities. These include a high density EEG suite, a fully-fitted sleep laboratory, a social observation suite, eye-tracking, psychophysiological, tDCS and conditioning labs, a lifespan lab and baby room, and over 20 all-purpose research rooms.

Having a Master’s by research degree shows that you can communicate your ideas and manage tasks. Jobs in academia, education, government, management, the public or private sector are possible. 

Health Economics and Decision Science MSc

London, Bloomsbury

The UCL MSc in Health Economics and Decision Science spans the disciplines of Economics, Epidemiology, and Statistics, providing students with outstanding theoretical foundations and the ability to solve applied real-world problems. This degree offers a unique multidisciplinary environment for people aiming to tackle global health challenges using advanced quantitative techniques.

UK tuition fees (2024/25)

Overseas tuition fees (2024/25), programme starts, applications accepted.

Applications closed

Applications will be reviewed in batches. The outcome of applications will be released according to the following timeline: Oct– Dec applicants: End of Feb Jan – Feb applicants: Early Apr March applicants: End of May

• Entry requirements

A minimum of an upper second-class UK Bachelor's degree or an overseas qualification of an equivalent standard in economics, statistics, mathematics or a related quantitative field such as epidemiology, engineering or physics.

The English language level for this programme is: Level 2

UCL Pre-Master's and Pre-sessional English courses are for international students who are aiming to study for a postgraduate degree at UCL. The courses will develop your academic English and academic skills required to succeed at postgraduate level.

Further information can be found on our English language requirements page.

Equivalent qualifications

Country-specific information, including details of when UCL representatives are visiting your part of the world, can be obtained from the International Students website .

International applicants can find out the equivalent qualification for their country by selecting from the list below. Please note that the equivalency will correspond to the broad UK degree classification stated on this page (e.g. upper second-class). Where a specific overall percentage is required in the UK qualification, the international equivalency will be higher than that stated below. Please contact Graduate Admissions should you require further advice.

About this degree

The MSc in Health Economics and Decision Science integrates economics and statistics as applied to health and health care. Students are provided with rigorous, and world-leading foundation skills in health economics and decision science via the completion of core modules, and can gain an advanced level of specialisation by choosing optional modules that further their own special interest areas in the economics of health and health care. In addition to developing their subject knowledge and skills, students are also provided with opportunities to work collaboratively with others, as well as to lead their own research. All students will graduate with an advanced understanding of how the political, economic, and physical context of health systems frames the application of health economics and decision science to strengthen health systems and achieve equity in health outcomes.

Who this course is for

This programme is intended for applicants with a suitable qualification (see entry requirements) in economics, statistics, mathematics, or a related quantitative field such as epidemiology, engineering, or physics. Candidates with a background in medicine or allied health sciences may be considered if they can demonstrate quantitative proficiency in mathematics and/or statistics at the degree level.

What this course will give you

UCL offers a highly multidisciplinary environment in which to study health economics and decision science. The teaching team for this programme comprises economists, statisticians, epidemiologists, mathematicians, and public health doctors, among others. As a world-leading university, we research, publish, and consult on the topics we teach. Our strong links to industry, policy, and academia enhance the relevance of our teaching and the employment opportunities of our graduates.

The foundation of your career

As the global population grows and ages, so too does the challenge of providing equitable access to cost-effective healthcare. This MSc has been developed to fill a gap in training and skills in higher education, to embrace the multidisciplinary nature of health economics and decision science and provide you with a solid theoretical foundation - while allowing you to choose specific pathways within which you can focus on either more advanced modelling or advanced applied economics.

Employability

Thanks to longstanding strong links to industry and demand for skills in this area, graduates of this programme have the relevant skills and knowledge for a career within the pharmaceutical industry, local or national government departments, international organisations, think tanks, consultancies, or in academia, among other opportunities such as: the Ministry of Health, Office of Health Economics, UCL, Oxford University, King's College London, Frontier Economics, FIECON, IQVIA, and Evidera.

The UCL Institute for Global Health students have priority access to academic events held throughout the year. This includes UCL's prestigious Lancet Lecture series which showcases leading global health scholars working on key public health issues. Students also have access to internal events, such as meetings which bring together research being done across our three sites and lunchtime lectures featuring the research of the UCL Institute for Global Health staff and doctoral candidates. From 2023, academic staff will be hosting a series of events for students in order to provide informal spaces to discuss ideas, research, and provide career advice.

Teaching and learning

Teaching will be delivered using a wide range of methods including classroom teaching, peer-led seminars, online lectures and practical exercises, moderated debates, group exercises, and reading and writing tasks.

Assessments vary from written examinations to essays, portfolios, coursework, reports, and oral presentations.

Classes take place during business hours. Modules are delivered as blocks of study. The duration of modules ranges from two to eleven weeks. Core modules are normally taught over five or ten weeks, with 2-4 of lectures and 1-2 hours of tutorials/seminars per week. Optional modules are usually offered in two formats: long (three hours per week over 10 weeks) or short (three weeks, with teaching in the first two weeks on Monday, Tuesday, and Friday and the third week is for self-study).

For full-time students, you will undertake modules to the value of 180 credits, comprising eight taught modules worth 15 credits each and a substantive piece of student-led research that will carry 60 credits. You must undertake five compulsory modules and three optional modules. Students without an Economics undergraduate degree are required to take the Introductory Microeconomics for Health (GLBH0029) module from the optional modules list. Upon successful completion of 180 credits within 1 academic year, you will be awarded an MSc in Health Economics and Decision Science.

Students who are reading for this programme part-time are advised to take 90 credits each in their first and second year of study. Students are encouraged to get in touch with one of the Course Directors to discuss their module choices before finalising their selection.

We recommend that students take modules in the following order to ensure that all pre-requisites are met or that threshold knowledge is consolidated before taking advanced modules:

• Introductory Microeconomics for Health (GLBH0029) followed by Microeconomics for Health (GLBH0030) if you do not have an Economics degree
• Microeconomics for Health (GLBH0030) and Econometrics for Health (GLBH0028) followed by Health Economics (ECON0069)
• Statistics for Health Economics (STAT0039) followed by Bayesian Methods in Health Economics (STAT0019) and/or Medical Statistics 2 (STAT0015) for students starting from AY2021/22
• Economic Evaluation in Health Care (GLBH0022) followed by Modelling for Decision Science (GLBH0031)
• Dissertation module (GLBH0032) is required to be taken in their final year.

Students are encouraged to reach out to one of the Course Directors or Teaching Administrator for module selection advice before finalising their selection.

Compulsory modules

Optional modules.

Please note that the list of modules given here is indicative. This information is published a long time in advance of enrolment and module content and availability are subject to change. Modules that are in use for the current academic year are linked for further information. Where no link is present, further information is not yet available.

Students undertake modules to the value of 180 credits. Upon successful completion of 180 credits, you will be awarded an MSc in Health Economics and Decision Science.

A number of students will have the opportunity to undertake an industry placement over the summer. This will not be assessed as part of the programme and access to placements is voluntary and based on open competition.

Accessibility

Details of the accessibility of UCL buildings can be obtained from AccessAble accessable.co.uk . Further information can also be obtained from the UCL Student Support and Wellbeing team .

Fees and funding

Fees for this course.

Programme also available on a modular (flexible) basis .

The tuition fees shown are for the year indicated above. Fees for subsequent years may increase or otherwise vary. Where the programme is offered on a flexible/modular basis, fees are charged pro-rata to the appropriate full-time Master's fee taken in an academic session. Further information on fee status, fee increases and the fee schedule can be viewed on the UCL Students website: ucl.ac.uk/students/fees .

Additional costs

There may be additional costs for students undertaking primary data collection or secondary data analysis as part of the dissertation. Additional costs may include travelling, accommodation, translation services, etc.

The department offers several competitive travel bursaries each year to cover some of these costs.

For more information on additional costs for prospective students please go to our estimated cost of essential expenditure at Accommodation and living costs .

Funding your studies

All applicants may apply for the IGH Postgraduate Bursaries.

For a comprehensive list of the funding opportunities available at UCL, including funding relevant to your nationality, please visit the Scholarships and Funding website .

African Graduate Scholarship

Deadline: 31 May 20214 Value: £38,000 towards fees, accommodation and living costs (1 year) Criteria Based on both academic merit and financial need Eligibility: EU, Overseas

Commonwealth Shared Scholarship Scheme (CSSS)

Deadline: NOW CLOSED FOR 2024/25 ENTRY Value: Full fees, flights, stipend, and other allowances (1 year) Criteria Based on both academic merit and financial need Eligibility: EU, Overseas

Dr Keith Travel Bursary

Value: Varies () Criteria Based on academic merit Eligibility: UK, EU, Overseas

Students are advised to apply as early as possible due to competition for places. Those applying for scholarship funding (particularly overseas applicants) should take note of application deadlines.

There is an application processing fee for this programme of £90 for online applications and £115 for paper applications. Further information can be found at Application fees .

In addition to the generic application criteria, applicants to this programme are required to write a 500 word-long dissertation research proposal.  Please ensure that the proposal outlines the intended research question, includes a set of objectives, describes the methods you intend to use and suggests where you might find your evidence or data.  You might find it helpful to look at abstracts from open access journal articles to assist you with this task. However, be careful not to copy their wording as this would be considered plagiarism. During your time at UCL you will receive help in refining your topic and you may be able to change your topic if you have new ideas.

When we assess your application, we would like to learn:

• why you want to study Health Economics and Decision Science at graduate level
• why you want to study Health Economics and Decision Science at UCL
• what particularly attracts you to the chosen programme
• how your academic and professional background meets the demands of this challenging programme
• where you would like to go professionally with your degree

Together with essential academic requirements, the personal statement is your opportunity to illustrate whether your reasons for applying to this programme match what the programme will deliver.

We reserve the right to close application early if the programme is full. Applicants are recommended to submit applications early.  

Target Application Results Releasing Timeline

Oct– Dec applicants: End of Feb

Jan – Feb applicants: Early Apr

March applicants: End of May

Please note that you may submit applications for a maximum of two graduate programmes (or one application for the Law LLM) in any application cycle.

Got questions? Get in touch

Institute for Global Health

[email protected]

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95592 - DEVELOPING A RESEARCH PROPOSAL IN HEALTH ECONOMICS, MANAGEMENT AND POLICY

Academic year 2022/2023.

• Docente: Paolo Masella
• SSD: SECS-P/01
• Language: English
• Teaching Mode: Traditional lectures
• Campus: Bologna
• Corso: Second cycle degree programme (LM) in Economics and Economic Policy (cod. 8420)
• Teaching resources on Virtuale

Learning outcomes

At the end of the learning activity, the student has a thorough view of the main directions of current research in health economics, policy and management. He/she attains the ability to develop critical and original views on both empirical and theoretical directions of research.

Course contents

This course will guide students through the process of developing research ideas, gathering, processing, and analyzing the appropriate data, and effectively communicating their results.

Readings/Bibliography

The class will not be based on any specific textbook. Potentially useful sources, however, are:

• Mostly Harmless Econometrics and Mastering ‘Metrics .
• Matthew Gentzkow and Jesse Shapiro’s Code and Data for the Social Sciences
• The Sense of Style , by Steven Pinker, and The Elements of Style , by William Strunk.

Teaching methods

Slides and Blackboard

Assessment methods

Research proposal and presentation: Your grade will be based on a four-page research proposal and a 15-minute presentation

The maximum possible score is 30 cum laude, in case all anwers are correct, complete and formally rigorous.

The grade is graduated as follows:

<18 failed 18-23 sufficient 24-27 good 28-30 very good 30 e lode excellent

Teaching tools

Slides in PDF

Office hours

See the website of Paolo Masella

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Health Economics and Policy

• Entry year 2024 or 2025
• Duration Part time 4 - 7 years

The PhD in Health Economics and Policy meets the needs of those wishing to gain a deep and critical insight into health economics theory, research and practice and to develop or enhance research skills whilst fulfilling their existing responsibilities. The programme is offered part-time and combines innovative distance learning with face-to-face teaching at an annual autumn Academy held in Lancaster.

The programme is suitable for both UK-based and international students working in healthcare settings, pharmaceutical companies, international organisations, local and central government, consultancies, education or research.

This part-time, flexible doctorate runs over a minimum of four and a maximum of seven years. The programme begins with a compulsory five-day Induction Academy in Lancaster. Each of the subsequent academic years start with a compulsory three-day autumn Academy, while the rest of the course is delivered via e-learning. Attendance at the annual Academies is compulsory until students have been confirmed on the PhD programme.

Years 1 and 2 consist of taught modules delivered online that consolidate students’ knowledge of health economics and policy and develop their research skills. In Year 1 students take two specialist modules that cover the theory and practice of health economics and policy as well as a module on data analysis. Year 2 modules may include: Systematic Reviews, Research Philosophy, Research Design and Practical Research Ethics.

From Year 3 onwards, students undertake an independent research study , which will conclude with the submission of a thesis that makes an original contribution to knowledge. The research project will be supervised from the University but undertaken in students’ own location or workplace. Supervision meetings take place online. During the annual autumn Academy students meet with supervisors face to face.

The Health Economics at Lancaster (HEAL) team has expertise in health economics, health policy and economic evaluation. This expertise is being complemented by the expertise existing in the Economics department at Lancaster University Management School (LUMS).

Your department

• Division of Health Research Faculty of Health and Medicine
• Telephone +44 (0)1524 592032

Entry requirements

Academic requirements.

2:1 Hons degree (UK or equivalent) in economics, or other relevant discipline with a significant quantitative content such as statistics, pharmacy, medicine and management.

We may also consider non-standard applicants, please contact us for information.

If you have studied outside of the UK, we would advise you to check our list of international qualifications before submitting your application.

Additional Requirements

As part of your application you will also need to provide a 500 word research proposal. Guidance can be found on our writing a research proposal webpage.

English Language Requirements

We may ask you to provide a recognised English language qualification, dependent upon your nationality and where you have studied previously.

We normally require an IELTS (Academic) Test with an overall score of at least 6.5, and a minimum of 6.0 in each element of the test. We also consider other English language qualifications .

Contact: Admissions Team +44 (0) 1524 592032 or email [email protected]

Course structure

You will study a range of modules as part of your course, some examples of which are listed below.

Information contained on the website with respect to modules is correct at the time of publication, but changes may be necessary, for example as a result of student feedback, Professional Statutory and Regulatory Bodies' (PSRB) requirements, staff changes, and new research. Not all optional modules are available every year.

core modules accordion

e-learning distance module

Autumn Term (weeks 1-10, October – December)

Credits: 30

Mode of assessment : 3000 word essay (80%) and a poster (20%).

This module equips students with a set of economic tools to critically appraise issues in health and health care while offering a broad overview of the most relevant and current policy issues. The module begins with a review of microeconomic and statistical tools relevant for health economics. It then introduces an analytical framework for assessing a wide range of health systems. Next, the module looks at the demand for and production of health and health care, including the concept of supplier induced demand. Finally, the module introduces students to the key elements of economic evaluation.

Deadline: January

The aim of this module is to provide students with an advanced introduction to the methods commonly used in health research. Students will gain knowledge and understanding of:

• How to use Moodle for distance learning and engage with peers and staff online
• Using the library as a distance learning student
• How to search the literature
• Using End Note
• How to synthesise evidence
• Standards of academic writing
• The nature of plagiarism and how to reference source material correctly
• Theoretical perspectives in health research
• The practical process of conducting research
• How to formulate appropriate questions and hypotheses
• How to choose appropriate methodology
• Quantitative and qualitative research methods
• Research ethics
• Disseminating and implementing research into practice
• Programme-specific research.

Spring Term (weeks 1-10, January-March)

Mode of assessment : 5000 word essay

This module explores the philosophical underpinnings of research. It begins with an introduction to epistemology, i.e. the philosophical basis of knowledge and its development. It then considers the influence of different epistemological bases on research methodology and explores the role of theory and theoretical frameworks in the research process. It also examines the nature of the knowledge that underpins evidence-based policy and practice and introduces the fundamental principles of ethics.

Deadline: April

Sunmer Term (weeks 1-10, April-June)

Mode of assessment : 5000 word assignment consisting of two 2500 word components

This module introduces a range of methods used in health research. The focus is on justifying research design choices rather than practical skills in data analysis. The starting point is the development of meaningful and feasible research questions. The module then introduces a range of quantitative research designs and quantitative approaches to data collection. Next, the module looks at qualitative research designs and their relation to different epistemological positions, as well as how to integrate quantitative and qualitative methods into mixed methods research. The module also explores issues such as sampling and quality across different research designs.

Deadline: July

Spring term (weeks 1-10, January-March)

Mode of assessment : two pieces of written work (Qualitative data analysis, 2500 words; Quantitative data analysis, 2500 words)

This module is an introduction to the theory and practice of qualitative and quantitative data analysis. The module consists of two distinct parts: qualitative data analysis and quantitative data analysis. Within quantitative data analysis, there will be an option to take an introductory or an advanced unit.

The introductory quantitative unit covers data management and descriptive analyses and introduces students to inferential testing in general and statistical tests for comparisons between groups specifically. The advanced quantitative unit covers linear regression as well as regression methods for categorical dependent variables and longitudinal data before exploring quasi-experimental methods for policy evaluation and finally providing an opportunity to discuss more specific regression methods such count data models or duration analysis.

The qualitative unit focusses on the technique of thematic analysis, a highly flexible approach and useful foundation for researchers new to qualitative data analysis. The unit takes students through the stages of a qualitative data analysis: sorting and organising qualitative data, interrogating qualitative data, interpreting the data and finally writing accounts of qualitative data.

Summer Term (weeks 1-10, April-June)

Mode of assessment : A written assignment that includes: a) a 4000 word research proposal and b) a completed REAMS (Research Ethics Application Management System) application form and supporting documents.

This module completes the taught phase of Blended Learning PhD programmes. It enables students to put everything they have learned so far together and produce a research proposal that will provide the basis for the research phase of the programme.

The first part of the module – research design – starts by discussing the components of a research proposal according to different epistemologies and research methods. It then takes students through the process of developing their own proposal, starting with the topic and epistemological framework, through to the study design and data collection methods and finally the practical details.

The second part of the module – practical research ethics – teaches students how to think about their research proposal from an ethical perspective. It covers ethical guidelines and teaches students how to identify the purpose of a guideline, to enable them to translate their proposal into an ethical review application. Finally, students will prepare a practice research ethics application using the REAMS application review system.

Autumn term (weeks 1-10, October-December)

Mode of assessment : 5000 word assignment

This module provides an introduction to the principles and components of systematic reviewing. It takes students through the key steps of a systematic review. The starting point of the module is the construction of an appropriate review question. Next, the module discusses the (iterative) process of creating a search strategy that successfully identifies all relevant literature. The module then moves on to selecting appropriate methodological quality criteria, enabling students to develop their skills in critically appraising studies. After discussing how to prepare a data extraction form the module introduces a key component of a systematic review: synthesising the evidence. Finally, the module will teach students how to put everything together in a systematic review protocol.

Fees and funding

Home Fee £4,350

International Fee £11,340

General fees and funding information

Additional fees and funding information accordion

There may be extra costs related to your course for items such as books, stationery, printing, photocopying, binding and general subsistence on trips and visits. Following graduation, you may need to pay a subscription to a professional body for some chosen careers.

Specific additional costs for studying at Lancaster are listed below.

College fees

Lancaster is proud to be one of only a handful of UK universities to have a collegiate system. Every student belongs to a college, and all students pay a small College Membership Fee which supports the running of college events and activities. Students on some distance-learning courses are not liable to pay a college fee.

For students starting in 2024, the fee is £40 for undergraduates and research students and £15 for students on one-year courses. Fees for students starting in 2025 have not yet been set.

Computer equipment and internet access

To support your studies, you will also require access to a computer, along with reliable internet access. You will be able to access a range of software and services from a Windows, Mac, Chromebook or Linux device. For certain degree programmes, you may need a specific device, or we may provide you with a laptop and appropriate software - details of which will be available on relevant programme pages. A dedicated IT support helpdesk is available in the event of any problems.

The University provides limited financial support to assist students who do not have the required IT equipment or broadband support in place.

For most taught postgraduate applications there is a non-refundable application fee of £40. We cannot consider applications until this fee has been paid, as advised on our online secure payment system. There is no application fee for postgraduate research applications.

For some of our courses you will need to pay a deposit to accept your offer and secure your place. We will let you know in your offer letter if a deposit is required and you will be given a deadline date when this is due to be paid.

The fee that you pay will depend on whether you are considered to be a home or international student. Read more about how we assign your fee status .

If you are studying on a programme of more than one year’s duration, tuition fees are reviewed annually and are not fixed for the duration of your studies. Read more about fees in subsequent years .

Similar courses

Health studies.

• Clinical Psychology DClinPsy
• Dementia Studies PhD
• Health Data Science MSc
• Health Data Science PhD
• Health Economics and Policy MSc
• Health Research PhD
• Mental Health PhD
• Organisational Health and Well-Being PhD
• Palliative Care PhD
• Public Health PhD

Take an innovative approach to distance learning combining interactive lectures, webinars and online collaboration, group work and self-directed study.

Work with world-leading academics to make an original contribution to your area of professional practice.

Benefit from an international peer group that could include research professionals, policy-makers, pharmacoeconomists and global health professionals.

Studying by blended learning

The PhD in Health Economics and Policy is offered part-time via blended learning . Teaching and research activities are carried out through a combination of face-to-face and online interaction, allowing you to undertake the majority of study from your own location whilst fulfilling your existing responsibilities. You will benefit from being part of a UK and internationally-based peer group working across a range of sectors.

Face-to-face interactions take place at an annual residential autumn Academy while taught modules are delivered via distance learning using our virtual learning environment and include discussion forums, collaborative digital spaces and video conferencing. All students have access to a hub space that facilitates interaction with their cohort and with students on related programmes, creating a virtual information space that’s also sociable. An academic tutor will support you during the taught phase and two supervisors provide you with support in the research phase.

The Division of Health Research

The Division of Health Research have been offering blended learning postgraduate programmes since 2010. We have many successful graduates and currently around 200 continuing students on a range of programmes who have benefited in progressing their careers from the high quality postgraduate education we provide.

Health Economics at Lancaster (HEAL)

As a research group with strong collaborative links with the Economics department, the work undertaken by HEAL aims to have an impact on people's well being and society as a whole.

Athena SWAN: Gender Equality at Lancaster

We hold the Athena SWAN Silver Award, recognising our commitment to advancing the careers of women in higher education and research.

Social and Economic Inequality in Health Research

Our research illuminates the social determinants of inequalities in health to produce and exchange evidence to reduce these inequalities.

Important Information

The information on this site relates primarily to 2025/2026 entry to the University and every effort has been taken to ensure the information is correct at the time of publication.

The University will use all reasonable effort to deliver the courses as described, but the University reserves the right to make changes to advertised courses. In exceptional circumstances that are beyond the University’s reasonable control (Force Majeure Events), we may need to amend the programmes and provision advertised. In this event, the University will take reasonable steps to minimise the disruption to your studies. If a course is withdrawn or if there are any fundamental changes to your course, we will give you reasonable notice and you will be entitled to request that you are considered for an alternative course or withdraw your application. You are advised to revisit our website for up-to-date course information before you submit your application.

More information on limits to the University’s liability can be found in our legal information .

Our Students’ Charter

We believe in the importance of a strong and productive partnership between our students and staff. In order to ensure your time at Lancaster is a positive experience we have worked with the Students’ Union to articulate this relationship and the standards to which the University and its students aspire. View our Charter and other policies .

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Lifestyle Medicine and Economics: A Proposal for Research Priorities Informed by a Case Series of Disease Reversal

Affiliations.

• 1 American College of Lifestyle Medicine, Chesterfield, MO 63006, USA.
• 2 Department of Member Engagement & Administration, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA.
• 3 School of Nursing, Indiana University, Indianapolis, IN 46202, USA.
• 4 School of Medicine and Dentistry, University of Rochester, Rochester, NY 14620, USA.
• 5 Ardmore Institute of Health, Ardmore, OK 73401, USA.
• 6 Global Positive Health Institute, Sacramento, CA 95825, USA.
• 7 Department of Specialty Medicine, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA.
• 8 Bright Health Group, Minneapolis, MN 55437, USA.
• 9 BlueZones Well-Being Institute, Adventist Health, Roseville, CA 95661, USA.
• 10 Midland Health, Midland, TX 79703, USA.
• 11 Medical Center, University of Rochester, Rochester, NY 14642, USA.
• 12 Department of Research, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA.
• PMID: 34769879
• PMCID: PMC8583680
• DOI: 10.3390/ijerph182111364

Chronic disease places an enormous economic burden on both individuals and the healthcare system, and existing fee-for-service models of healthcare prioritize symptom management, medications, and procedures over treating the root causes of disease through changing health behaviors. Value-based care is gaining traction, and there is a need for value-based care models that achieve the quadruple aim of (1) improved population health, (2) enhanced patient experience, (3) reduced healthcare costs, and (4) improved work life and decreased burnout of healthcare providers. Lifestyle medicine (LM) has the potential to achieve these four aims, including promoting health and wellness and reducing healthcare costs; however, the economic outcomes of LM approaches need to be better quantified in research. This paper demonstrates proof of concept by detailing four cases that utilized an intensive, therapeutic lifestyle intervention change (ITLC) to dramatically reverse disease and reduce healthcare costs. In addition, priorities for lifestyle medicine economic research related to the components of quadruple aim are proposed, including conducting rigorously designed research studies to adequately measure the effects of ITLC interventions, modeling the potential economic cost savings enabled by health improvements following lifestyle interventions as compared to usual disease progression and management, and examining the effects of lifestyle medicine implementation upon different payment models.

Keywords: chronic disease; cost savings; diabetes remission; healthcare costs; lifestyle medicine.

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Conflict of interest statement

T.M.C. receives royalties from general interest books about nutrition and receives research funding from the Highland Hospital Foundation, which has received philanthropic donations from nonprofit organizations interested in nutrition education, including the T. Colin Campbell Center for Nutrition Studies, and various individual donors. He is founder/physician for an online practice (Thomas Campbell, MD, PLLC and Campbell Lifestyle Program, LLC) offering lifestyle medicine consultations and group programs.

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Article Contents

Data limitations in conducting health economics research focused on cancer treatment, opportunities in training of clinicians and health economists, economic analyses alongside clinical trials, recommendations for health economics research in cancer treatment.

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Health Economics Research in Cancer Treatment: Current Challenges and Future Directions

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James B Yu, Deborah Schrag, K Robin Yabroff, Health Economics Research in Cancer Treatment: Current Challenges and Future Directions, JNCI Monographs , Volume 2022, Issue 59, July 2022, Pages 51–56, https://doi.org/10.1093/jncimonographs/lgac009

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The National Cancer Institute Division of Cancer Control and Population Science hosted a virtual conference on the Future of Cancer Health Economics Research and included a presentation from a workgroup that considered current challenges and future directions in health economics research centered on cancer treatment.

The workgroup identified 3 broad categories of focus: data limitations, opportunities for training for clinicians and health economists interested in collaboration, and the need for prospective economic study of cancer treatment. Within these areas of focus, the workgroup recommended the following: improvement of the availability of key economic measures in data available to researchers, creation of more comprehensive datasets robust to insurance type or coverage, development of cancer care health economics research-focused symposia, instituting clear mechanisms to support integration of economic analyses alongside clinical trials, development of standardized methods to measure the cost of cancer care to health-care systems and patients, and development of standardized evaluations that include measures of social determinants of health.

Cancer treatment lies at the center of the health economics research framework ( Figure 1 ) ( 1 ). Health economics research that focuses on cancer treatment evaluates how patients, health-care providers, insurers, and governments make decisions with respect to cancer treatment using economic theory, models, and empirical methods that can involve analyses of observational data sources such as insurance payments or primary data collection. More comprehensive and timely observational data are needed. Additionally, prospective evaluations of economic factors alongside clinical trials of novel therapies are also needed. Given the increasing expense of cancer treatments ( 2 , 3 ) and growth in the number of cancer patients and survivors ( 4 ), health economics research of cancer treatment is critically important to inform patients, health-care providers and payers, and the public about the relative economic value of cancer treatments.

Cancer health economics research framework. (Adapted from Halpern et al. A framework for cancer health economics research. Cancer . 2021;127:994-996. 1 QALY = quality adjusted life year.

Cancer treatment is diverse and evolves quickly. Multiple types of cancer treatment (surgery, radiation therapy, oral and intravenous chemotherapy, immunotherapy, molecularly targeted therapy, cellular therapy, nonradiotherapy locally ablative treatment, etc.) exist in combinations and sequences that vary by cancer site, stage, and molecular characteristics. Furthermore, novel treatments such as molecularly targeted and immune-modulating therapies are rapidly introduced, with thousands of potential treatments in the development pipeline ( 5 ). Even for treatments with extensive existing literature such as radiotherapy, treatment intensity, and duration are often varied to balance convenience, quality of life, and effectiveness.

The rapid pace of innovation and change occurs in an environment with constrained national health-care resources and can result in high cost burdens for patients ( 6 ). To make the best health-care decisions regarding cancer treatment, patients, providers, insurers, and payers need access to reliable trustworthy information about the economic value and effectiveness of cancer treatments.

In light of these issues, a workgroup was convened to develop a subsequent panel presentation for the National Cancer Institute (NCI)–hosted conference on the Future of Cancer Health Economics Research about the current challenges and recommendations for future directions in health economics research investigating cancer treatment. This document summarizes discussions leading up to the workshop as well as the presentation and discussion from December 2, 2020. The workgroup, led by Dr Robin Yabroff, included Drs Deborah Schrag, Henry J. Henk, Stephanie B. Wheeler, Ya-Chen Tina Shih, Marc Smaldone, and James Yu. The workgroup identified 3 broad categories of focus: data limitations, opportunities for training for clinicians and health economists interested in collaboration, and the need for prospective economic analysis of treatments being evaluated in clinical trials.

Critical to any health economics research of cancer treatment is the availability of contemporary and comprehensive data characterizing either expenditures or resource utilization that can be converted to expenditures. Most commonly, administrative data from public and private health insurers are used to evaluate cancer treatment expenditures. Because cancer is a disease associated with aging and because the Medicare program insures almost all Americans older than age 65 years, Medicare claims are the most important source for characterizing cancer treatment. The linkage of Medicare data to NCI’s Surveillance, Epidemiology, and End Results (SEER) data makes measurement of the costs and evaluation of factors associated with cancer treatment for specific tumor and treatment types relatively straightforward, as the population-based SEER registries collect information about cancer diagnoses and survival among a representative sample of the US population. Examples of potential data resources in health economics research are shown on Table 1 . Though these data are quite useful for some studies, there are critical gaps in available data, especially for researchers evaluating aspects of cancer treatments. Notably, information about patient eligibility for treatment or key measures of treatment outcomes (other than survival), including response, recurrence and location of recurrence, or health-related quality of life, are not currently available from the data sources listed ( 7-9 ). Though technically the International Classification of Diseases version 10 diagnosis codes may indicate secondary malignant neoplasms, prior work has shown these codes have limited utility for inferring stage and/or recurrence because of limited sensitivity and specificity ( 7–9 ). In addition, there is a lag in data availability. This means that economic evaluations of new treatment approaches that rely on administrative data are typically delayed by several years. The workgroup also noted key clinical and economic measures that would be helpful for health economics research ( Table 2 ).

Characteristics of selected data sources and research resources in the US for health economics research in cancer treatment

Data on Medicare Part D prescription drug services are available starting in 2006. MEPS = Medical Expenditure Panel Survey; SEER = Surveillance Epidemiology and End Results.

Diagnosis codes exist for secondary malignant neoplasms, although caution is advised for interpretation as disease recurrence, even with careful analysis.

Key measures for health economic research of cancer treatment

The reliance of most economic studies of cancer treatment on existing health insurance claims data means that inferences regarding cancer treatment choice can be clouded by rapid and frequent changes in insurance benefit design or by changes in plans among working-age adults. Furthermore, the data linkages to insurance claims (eg, SEER-Medicare) provide information about cancer characteristics and treatment only for select populations (such as those enrolled in Medicare fee-for-service). Detailed information about treatment and many outcomes end when health insurance coverage ends or changes, especially for the population aged younger than 65 years who are not age eligible for Medicare coverage. For Medicaid, median enrollment in state-federal Medicaid programs is less than 10 months, which means that these data will be limited for evaluating longer-term patterns of care ( 10 ). Low-income adults in particular are at risk for changing insurance coverage due to job-related changes and loss of eligibility for Medicaid or Affordable Care Act Marketplace subsidies ( 11 ). Furthermore, the transitions in coverage can be meaningful in and of themselves (switch to disability, unemployed because of cancer, and loss of employer-sponsored coverage).

In addition to a lack of comprehensive data on measures, the workgroup noted a lack of real-time data, making health economics research on contemporary practice patterns more difficult. Beyond health economics research, informing current practice with data obtained in a continuous and up-to-date manner is the goal of a learning health- care system , which is defined as a health-care system in which knowledge is continuously generated and cycled back into daily practice, which then creates more knowledge regarding best practice in cycle of continual improvement and learning ( 12 ). Health economics research of cancer treatment plays a critical part of this learning health-care system by taking observational and administrative data from real-world cancer treatment and analyzing these data to inform best practices.

Timeliness of analysis is especially challenging with rapid changes in treatments. Further, as innovations in cancer treatment do not occur uniformly for all people and providers, there are trade-offs between timeliness of analysis and representativeness of the data analyzed. Finally, reliance on historical data is less useful for research to inform modern changes in benefit design (eg, high deductible health insurance plans, bundled payment, value-based payment) that may not have historical precedents.

To address these limitations, the workgroup prioritized improving capacity for collection of economic data from large prospective cancer cohorts and clinical trials with streamlined and standardized economic data collection at baseline and defined follow-up. This approach could facilitate understanding patient’s direct medical expenses as well as indirect expenses for alternative treatment approaches. However, the workgroup did not have a specific recommendation as to what should be included in streamlined and standardized economic data collection.

The workgroup recognized a need for training and engagement of clinicians without a formal health economics background and for health services researchers and economists without formal clinical training. Health economics research that informs clinical practice requires the marriage of diverse skillsets that cross disciplinary boundaries.

Economic theory, methods, and analytic techniques are not taught in medical school, nursing school, or other clinically focused training programs, and therefore, to understand and measure economic inputs and outcomes, clinicians require further education to be knowledgeable research partners. Training intensity of clinicians can vary depending on the end goal. Fellowship-level training or NCI career development awards are available for clinicians who are interested in a career in health economics. More formally, health economics master of public health programs exist for those who can commit the time and effort required for completion. Short courses and intensive workshops can equip physician researchers with the skills necessary, but partnerships with formally trained economists or research methodologists are optimal. NCI and academic medical centers can use their convening power to create opportunities for investigators with complementary skill sets to form partnerships. Given the complexity of clinical cancer care, further efforts beyond those discussed at the workshop may be needed.

For health services researchers and health economists, clinical knowledge of cancer treatment is difficult to obtain. As obtaining a medical degree and completing a residency and fellowship are rarely feasible for health economics researchers, comprehensive knowledge of the rapidly changing care across the cancer control continuum will likely require partnering with clinicians. Again, focused meetings and collaborative seminars may be an optimal combination of efficiency and timeliness.

Suggestions for meetings and seminars to increase collaboration included the creation of specific sessions for cancer health economics research at both clinical (such as the American Society for Clinical Oncology, American Society for Radiation Oncology, and American Association for Cancer Research) and economic and health services research (such as Academy Health and American Society for Health Economics) meetings. The Cancer Care Delivery Research committees of National Clinical Trials Network groups are potentially fertile places for collaboration between clinicians and health economists. Finally, dedicated annual or biennial meetings of cancer health economics was also recommended, to bring focused attention to health economics research. Professional organizations (such as the American Society for Clinical Oncology, Academy Health, and American Society of Health Economists) can play a critical role in facilitating these collaborations.

Prospective clinical trials often address whether a new treatment will be an improvement over an older standard of care. Randomized controlled trials still offer most unbiased estimate of whether a treatment can work. However, randomized controlled trials are rarely designed to answer whether the new treatment has incremental economic value and often do not concern themselves with the actual cost of the new treatment. Costs can encompass both medical and nonmedical direct costs, such as the cost of treatment and the cost of transportation to the treatment, as well as indirect costs, such as premature death or the need to take early retirement. Economic analysis aims to assess all of these costs to answer the following questions: Is a new treatment worthwhile? And worthwhile to whom?

When asking whether a new treatment is worthwhile, health economics research also asks the following: Are anticipated differences in economic resource utilization meaningful from a societal perspective? Will adding an economic component influence clinical practice or health policy? Is collection of good economic data feasible within the context of the overall trial design? Does the trial design have external validity from an economic perspective?

To perform health economics research within a randomized study, the researcher must have data that captures baseline information (ideally including direct and indirect costs) on all participants, tracks resource utilization (especially big-ticket items like hospitalizations) for participants, and estimates medical costs from resource utilization. These data are best collected prospectively.

Despite the advantages of embedding health economics research into randomized trials, the NCI Cancer Therapy Evaluation Program and Division of Cancer Prevention do not provide funding for this research, and proposals to integrate economic companions alongside clinical trials are rarely approved. Similarly, the NCI Biomarker, Imaging and Quality of Life Studies Funding Program, which is used to fund correlative science associated with NCI clinical trial concepts or protocols, cannot be used to fund comparative effectiveness or cost-focused studies. Therefore, researchers interested in health economics can be stymied in their ability to obtain funding to support these studies although the incremental costs of economic analyses are typically very small in relationship to clinical trial costs.

Finally, although prospective economic data are ideal, they may be difficult to directly obtain within clinical trials. Further, prospectively collected economic data may be limited by participation bias, resulting in potentially misleading research findings if this bias is not adequately adjusted for or anticipated. Other methods to obtain economic data alongside clinical trials exist when prospective data collection is not possible within the trial itself. Data on the direct medical costs of clinical trial interventions can be obtained by measuring resource utilization from electronic health records or patient reporting. Administrative data can also provide estimates of direct medical cost accrued by patients. Indirect medical cost estimates can be found by surveying trial participants, caregivers, and providers using common data forms. These data can be collected prospectively during the course of the trial though this often requires additional funding through sources outside the NCI and National Institutes of Health.

Fundamental questions in health economics include questions of incremental cost effectiveness, true health system and patient costs of treatment (direct and indirect costs), measurement of productivity loss (eg, days lost from work), and the influence of economic factors on treatment itself. To answer these fundamental questions, the following interventions are recommended.

Improve availability of key economic measures when designing or updating existing or planned data registries ( Table 2 ) through standardized economic data collection at baseline and follow-up. Ideally, this should include social determinants of health.

Create more comprehensive datasets that include patients from all payers (eg, all payer claims database).

Increase availability of real-time data to researchers to better inform contemporary care delivery within a learning health-care system.

Creation of health economics–focused symposia within major cancer treatment society meetings as well as meetings dedicated to health economics research to bring focused attention to health economics research and cancer care.

Provide a clear mechanism to support integration of economic analyses that rely on standardized methods and approaches to data collection alongside clinical trials of cancer treatment.

Develop transparent and standardized measurement methods of the cost of care to health-care systems that facilitate comparison across treatments.

Develop and deploy standard methods to estimate the economic burden of treatment on patients in terms of time, out-of-pocket costs, and productivity.

In conclusion, the workgroup identified the need to address data limitations, improve collaborative opportunities for clinicians and health economists, and increase prospective economic study within and alongside clinical trials as 3 areas of focus for improving health economics research of cancer treatment. To address these areas, the workgroup recommended the following: improvement of the availability of key economic data, creation of datasets robust to insurance changes, development of focused symposia, instituting clear mechanisms to support prospective economic analyses alongside clinical trials, development of standardized methods to measure the cost of cancer care, and development of standardized evaluations that include measures of social determinants of health.

No funding was used for this study.

Role of the funder: Not applicable.

Disclosures: James B. Yu, MD, MHS, reports personal fees (speaking and consulting) from Boston Scientific and personal fees (advisory board) from Galera Pharmaceuticals. Dr Schrag acknowledges funding from the National Cancer Institutes (1UM1 CA233035-01). Dr Schrag received compensation for speaking at a Pfizer satellite symposium in 2019, receives services for editorial work for JAMA, and obtained research funding from the AACR for project GENIE. Dr Yabroff serves on the Flatiron Health Equity Advisory Board.

Author contributions: All authors contributed to the conceptualization and writing of the original draft, as well as reviewing and editing the manuscript.

Acknowledgments: The authors would like to acknowledge Drs Henry J. Henk, Stephanie B. Wheeler, Tina Shih, and Marc Smaldone for their participation in the cancer treatment workgroup, which this manuscript summarizes.

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Cancer Health Economics Research: The Future Is Now

Michael t halpern.

Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA

Joseph Lipscomb

Department of Health Policy and Management, Rollins School of Public Health, and Winship Cancer Institute, Emory University, Atlanta, GA, USA

K Robin Yabroff

Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA

The goals of the “Future of Cancer Health Economics Research” virtual conference were to identify challenges, gaps, and unmet needs for conducting cancer health economics research; and develop suggestions and ideas to address these challenges and to support the development of this field. The conference involved multiple presentations and panels featuring several key themes, including data limitations and fragmentation; improving research methods; role and impacts of structural and policy factors; and the transdisciplinary nature of this field. The conference also highlighted emerging areas such as communicating results with nonresearchers; balancing data accessibility and data security; emphasizing the needs of trainees; and including health equity as a focus in cancer health economics research. From this conference, it is clear that cancer health economics research can have substantial impacts on how cancer care is delivered and how related health-care policies are developed and implemented. To support further growth and development, this field should continue to welcome individuals from multiple disciplines and enhance opportunities for training in economics and in analytic methods and perspectives from across the social and clinical sciences. Researchers should continue to engage with diverse stakeholders throughout the cancer community, building collaborations and focusing on the goal of improving health and well-being.

Synthesis of the “Future of Cancer Health Economics Research” Virtual Conference

In synthesizing the findings and recommendations from the “Future of Cancer Health Economics Research” virtual conference, it is useful to revisit the goals of the conference as stated in the introduction to this Supplement: identify challenges, gaps, and unmet needs for conducting cancer health economics research; and develop suggestions and ideas to address these identified challenges and to support the development of this field ( 1 ). The first 2 presentations of this conference, which are described in separate articles in this Supplement, sought to identify current challenges in conducting cancer health economics research. The portfolio analysis of funded National Cancer Institute (NCI) grants from 2015 to 2020 found that only a small proportion of these grants (approximately 1%) included economic analyses, and these were generally not the primary focus of the grants ( 2 ). Most of the funded research has been in cancer prevention and screening. In contrast, the review of published studies in cancer health economics research found that most focused on treatment ( 3 ).

The graphic Framework for Cancer Health Economics Research, referenced in several presentations, provides an opportunity to think about gaps and unmet needs, including research areas that have not been well studied ( Figure 1 ) ( 4 ). Starting with the “inputs” component of the Framework, there has been little research on the effects of health insurance benefit design on cancer care and outcomes. Benefit design may be important not only for reducing out-of-pocket costs and financial hardship for individuals with cancer, but also for reducing use of low-value, unnecessary, and potentially harmful cancer care services ( 5 ). These inputs affect economic outcomes across the cancer control continuum for both individuals and populations. Also understudied is the “structural factors” component of the Framework, including the role of the cancer care workforce, health-care organizations, and availability of personnel, services, and technology in the economics of cancer care. “Policy factors” such as payment models, mandates, and innovation and diffusion of technology have received more attention over the past few years, with a particular focus on the impacts of provisions in the Affordable Care Act such as Medicaid Expansion and the Oncology Care Model from the Centers for Medicare and Medicaid Services. “Factors” represent influences that, in general, are at a larger context level than are inputs. Regarding the “outcomes” components of the Framework, the conference focused on emerging areas, including financial hardship, employment impacts, and health equity, where there has been only limited cancer health economics research.

Framework for cancer health economics research. This figure illustrates key inputs, patient- and population-level outputs, and structural and policy factors important to consider in cancer health economics research ( 4 ). Figure reprinted with permission from John Wiley and Sons.

Health Economics Research Across the Cancer Continuum: What We Have Learned, What Lies Ahead

Four presentations highlighted the challenges and unmet needs in cancer health economics research focused, respectively, on prevention, screening and diagnosis, treatment, and survivorship and discussed next steps to address these challenges ( 6-9 ). Several common themes emerged from these 4 presentations and the 2 discussions following the presentations, highlighting areas including data, methods, structural and policy factors, and transdisciplinary collaborations. First, a key issue is data limitations and fragmentation. Data are central to health economics research across the cancer control continuum, yet many data sources are limited to individuals who have a specific type of insurance or who receive care in a restricted geographic region or from a specific set of health-care organizations. This can limit the generalizability of research findings and prevent adequate longitudinal assessment, particularly among individuals who change health insurance or move to different regions. Additional limitations of data resources frequently used for cancer health economics research include limited or no information on:

• Exposures and risk factors;
• Social determinants of health, social needs, and social risk factors;
• Provider and provider practice characteristics;
• Molecular markers and other factors that may determine whether a patient’s cancer is appropriate for certain treatments;
• Patient-provider communications, provider treatment recommendations, and patient treatment preferences;
• Patient-reported outcomes; and
• Detailed clinical outcomes such as cancer recurrence.

Many of these data items would be considered inputs in the Framework illustrated in Figure 1 . Provider practice characteristics and provider treatment recommendations can be classified as structural factors, and patient-reported outcomes and clinical outcomes are clearly “outcomes” in this Framework. In addition, caregiver information is also absent from most data resources. This type of information is critical to evaluate the overall burden of cancer and potential interventions that extend beyond patients to effects on the health and financial well-being of family members.

Another important data limitation is timeliness; there are almost always substantial delays between when cancer care interactions (across the cancer control continuum) occur and when data on these interactions are available to researchers. Much of this delay may be unavoidable due to issues of data transmission, cleaning, verification or validation, deidentification, and other necessary steps. That is, there may be necessary trade-offs between having high-quality data and having timely data. Similarly, there may be trade-offs between having comprehensive data and having timely data: the more complete a cancer data resource is or the more sources it draws from, the greater the time between patient interaction and availability of data to researchers. It is also important to consider when access to timely data is highly important (eg, economic assessments of recently introduced interventions) vs when it is less critical (eg, examining mediating or moderating effects of structural factors on associations between costs and outcomes). Overall, it would be worthwhile exploring approaches that optimize the timeliness of cancer care data without sacrificing data quality or comprehensiveness.

There were multiple opportunities discussed to improve data for cancer health economics research. Opportunities discussed included:

• Creating new linkages between existing data resources. This is an ongoing activity by multiple organizations, for example, by the NCI Healthcare Delivery Research Program involving Surveillance, Epidemiology and End Results (SEER)Program-linked data resources;
• Creating new linkages between existing data resources and novel or newly collected data. New types of information sources such as social media and reports on consumer spending patterns are being incorporated into cancer health economics research; and
• Developing or incorporating standardized economic measures in secondary data sources as well as prospective clinical trials and cohort studies. Examples of economic measures could involve episodes of care, including development of standardized costs, for a defined treatment interval.

These opportunities are discussed in more detail in other articles in this supplement ( 6–11 ).

The next common theme to improve cancer health economics research to emerge from the conference related to methods. One example, noted in several presentations, is to increase the use of modeling. Modeling has frequently been used to project costs and outcomes for cancer prevention and screening (eg, studies by CISNET, the Cancer Intervention and Surveillance Modeling Network) but less frequently for survivorship. Moreover, modeling has had only limited use in assessments of cancer-relevant policies, cancer care guidelines, health insurance benefit design, potential effects of alternative payment models, and strategies to enhance equity in cancer care. Other methods-related topics highlighted during the conference included application of evolving data science methods, such as machine learning, which will likely provide important opportunities for advancing cancer health economics research. New methods to better understand and incorporate the perspectives of decision makers are also needed. These may include, for example, use of value of information analysis (ie, formal assessment of the cost of acquiring information or conducting research compared with the benefit of the research results in reducing uncertainty) ( 12 ) to help inform decisions about whether to invest in additional data resources that could improve the accuracy or precision of economic analyses.

Another common theme emerging from the conference focused on increased opportunities to study the role and impacts of structural and policy factors. These factors (and their effects on cancer care delivery) include the organization of cancer care and associated market issues; overuse, underuse, and misuse of cancer care services; diffusion of innovation; deimplementation of low-value care; and the role of local context in cancer care delivery. Closely linked to both structural and policy factors, there is also a tremendous need for more cancer health economics research focused on underserved populations. Although there is already a large body of research describing the costs and outcomes associated with cancer health disparities ( 3 , 13–15 ), research is now needed to examine economic factors associated with (and resulting from) strategies to address disparities in cancer care as well as the implementation and diffusion of strategies shown to be effective.

A final common theme discussed was cancer health economics research as a transdisciplinary field. As such, many of the opportunities for advancement noted during the conference involve collaborations among researchers in different disciplines and the training of individuals with diverse backgrounds. Collaborations may involve health economists, health services researchers, clinicians, epidemiologists, data scientists, policy makers, patient advocates, and patient stakeholders. There are existing opportunities for cancer health economics researchers to interact more frequently and effectively with existing research networks such as clinical trial cooperative groups, some of which are very interested in the economic aspects of cancer care. Researchers from implementation science brought important insights to the conference; there are opportunities to partner with these colleagues as well as learn from their efforts in advancing this field. Parallel to the transdisciplinary collaborations critical for cancer health economics research, cross-disciplinary training will be increasingly important for the next generation of researchers.

Conference Panels

The conference included 3 panels, with focused discussions around the theme “what do we need to do to be successful?” The communications panel highlighted the need to go beyond peer-reviewed publications and consider social media, lay press (eg, “op-eds”), and other approaches for disseminating research to policy makers and nonresearcher audiences. The data resources panel discussed enhancements that included new types of information, novel linkages, and use of social media data. The panel noted the importance of sharing data for novel projects that may be unrelated to the objectives for which the data were originally collected; given the substantial costs of data collection and curation, facilitating strategic reuse is critical. The health equity panel stressed that improving health insurance coverage is necessary but not sufficient to reduce cancer care disparities; diverse policies and other government, health-care system, and employer levers are important for achieving equity. The panel also highlighted disparities in clinical trial participation and the value of using “natural experiments” to explore strategies to address disparities.

There was much discussion about the importance of funding support to enhance the technical quality and policy relevance of cancer health economics research as well as interest in career development awards and training grants to support the future of this field. There was also substantial interest in developing “centers of excellence” in cancer health economics research and in incorporating health economic components in existing NCI-funded networks and potential future networks. Other opportunities discussed included targeted supplements for select health economics research questions, which would permit rapid funding and study initiation; providing expanded opportunities for the Cancer Intervention and Surveillance Modeling Network to investigate economic outcomes and related policy questions; and funding economic analyses in parallel with (ie, alongside) clinical trials.

Conference Breakout Sessions

The 4 conference breakout sessions raised additional important subjects and expanded on topics that had been discussed earlier related to training programs, fostering transdisciplinary collaborations and team science, data accessibility and data security, and methods development. Each group lived up to the moniker of being an “action” breakout session, proposing specific and actionable steps that could be implemented to advance cancer health economics research.

The training program session suggested introducing a webinar series for trainees interested in cancer health economics research across different institutions. This session also recognized the importance of training in communication with lay audiences and of health equity as part of training in this field; this training should be conducted jointly with community-based organizations or other community stakeholders to ensure that trainees have exposure to diverse, nonresearcher audiences and an understanding of the importance of activities such as community-based participatory research. The transdisciplinary collaborations session discussed how collaborations could improve economics research as well as barriers to and promoters for achieving effective collaborations. Having cancer health economics as a central aim in grants may be important for collaborations. Session participants suggested that the NCI could facilitate “matchmaking” between researchers in different disciplines at conferences such as this one.

The data accessibility and data security session highlighted changes in rules at the National Center for Health Statistics data centers that will facilitate support for health economics research. Session participants discussed the need for high levels of protection for confidential patient information and the development of flexibility in government rules related to data sharing. To achieve the dual aims of data accessibility and data security, improvements in data deidentification and data linkages may be important. The methods development session discussed the importance of transparency in details of analyses (eg, the specific billing codes used to identify a set of medical care services); the need for information, such as costs and Quality Adjusted Life Years (QALYs), to be readily accessible as a cancer health economics research “public good” to a range of researchers; and the relevance and trade-offs of different types of “real world data” (ie, representing the range of actual clinical practice) in economic analyses. Recommendations from this session included advocating for funding opportunities for economic methods; recruiting appropriate economic reviewers for study sections; learning to write for nontechnical audiences and producing tutorial documents; sharing programs and coding used for research projects; and facilitating collaborations involving clinicians and clinical fellows, health economics researchers, and policy makers to ensure that studies and findings are methodologically rigorous and have clinical and policy relevance.

Conclusions From the Conference

The introduction to this Supplement posed the (somewhat rhetorical) question: is now the time for the future of cancer economics research? Based on the presentations and discussions at the conference, we believe the answer is “yes”—the future is now. Cancer health economics research has evolved from a relatively niche field to an established discipline. It is poised to have a substantial impact on how cancer care is delivered and how policies are developed and implemented.

There are several conclusions that can be drawn from this conference. First, it is clear that cancer health economics research is a field involving synthesis, that is, “putting together different entities to make a whole which is new and different” ( https://www.medicinenet.com/synthesis/definition.htm ). Data resources used in cancer health economics research frequently combine information from disparate sources, for example, cancer registries, clinical records, medical claims, and surveys. For research in this field, clinical trials and models are fused, patient-reported outcomes and clinical measures merged, and social risk factors and legislative policies joined. A strength of the field is its fluidity, its ability to adapt, to take information from all sources.

Related to this concept of synthesis, it became clear in planning, conducting, and reviewing the “Future of Cancer Health Economics Research” virtual conference that much of this research is performed by individuals who, although having economics training, do not have graduate degrees in economics. Cancer health economics research is by design and by necessity a transdisciplinary field and not solely a subdiscipline of economics. Cancer health economics researchers have their primary training in fields including epidemiology, health services research, statistics, policy analysis, clinical medicine, and other areas, as well as economics. As such, the future of cancer health economics research will involve not only welcoming individuals from multiple disciplines; it will absolutely need individuals from multiple disciplines to grow and achieve its potential. One component of this will be to enhance opportunities for training in economics and in analytic methods from other disciplines to support this transdisciplinary area of research. Complementing this, it will be important to provide additional training opportunities related to cancer control for individuals with a general economics or health services research background.

Related to this theme of planning for the future is the important allied question: What is the scope of cancer health economics research? As was clear from many of the presentations, panels, and breakout sessions, this is not a field practiced in academic solitude. Researchers in this field are not afraid to “get their hands dirty,” work on policy initiatives, interact with community stakeholders, or speak with members of a legislative body. In addition to its transdisciplinary nature, cancer health economics research also needs on-the-ground input from cancer survivors, patient advocates, caregivers, health-care professionals, and policy makers. An essential component of this field, and one that differentiates it from certain other areas of economics, is a relentless focus on the “real world” and a primary objective of improving health and well-being. It was apparent that conference participants shared a sense of purpose about what this field can and should accomplish.

This shared sense of purpose also leads to thoughts of the future. Although this conference was hosted by the National Cancer Institute’s Division of Cancer Control and Population Sciences, it came about through the efforts of individuals from multiple agencies and organizations. Some of the work discussed at the conference will be continued through HEROiC, the Interagency Consortium to Promote Health Economics Research on Cancer ( https://healthcaredelivery.cancer.gov/heroic/ ). For those who wish to participate in helping set the direction for this field, there are multiple opportunities to be engaged, help build collaborations, and identify next steps. Individuals can obtain more information from the NCI Healthcare Delivery Research Program’s Cancer Health Economics Research website ( https://healthcaredelivery.cancer.gov/cancer-health/ ) and from other organizations and societies involved in research and conferences in this area. Although definitely not a comprehensive list, professional societies (in alphabetic order) whose conferences often involve cancer health economics research presentations include (but are not limited to):

• AcademyHealth (academyhealth.org)
• American Association for Cancer Research (aacr.org)
• American Public Health Association Cancer Forum (apha.org/apha-communities/forums/cancer-forum)
• American Society of Clinical Oncology (asco.org)
• American Society of Health Economists (ashecon.org)
• American Society of Preventive Oncology (aspo.org)
• International Health Economics Association (healtheconomics.org)
• ISPOR (ispor.org)
• Society for Medical Decision Making (smdm.org)

Future activities by the NCI Healthcare Delivery Research Program and the Interagency Consortium to Promote Health Economics Research on Cancer (HEROiC) include plans to bring together government agencies and nonprofit organizations to identify opportunities to further strengthen the agenda for cancer health economics research.

At present, the number of interesting and important cancer health economics research questions almost certainly outstrips the supply of trained investigators to explore these questions. For the future, it is important to consider priorities. Specifically, how can cancer health economics research be most effective in helping patients, families, health care provider, health-care systems, policy makers, and others across the cancer control continuum? Where should research efforts be concentrated, particularly in view of limited research resources and the compelling need to address inequities? Clearly, there are no easy answers to these questions, but they do provide useful guideposts for future development of this field.

To help enhance the future of cancer health economics research, we hope all of those who participated in the conference—and all those who now study its findings and recommendations in this monograph—will take up this call to action. This may involve creating new research collaborations by reaching out to unaccustomed partners, including researchers in unfamiliar departments, institutions, or organizations; policy makers and government officials; health-care systems, health-care providers, and professional societies; or cancer survivors, caregivers, community leaders, and patient advocates and patient advocacy organizations. This may involve offering to help with or lead new activities at future conferences that will strengthen cancer health economics research. It may involve volunteering to be a grant reviewer or to write a grant proposal with new research collaborators, such as community-based groups. It may involve learning new research methods or mentoring a colleague (or future colleague). None of these are easy, and they involve investments of time and additional research resources. However, they are key for the growth of cancer health economics research.

Role of the funder: No funding was received for this study and the authors indicate no conflicts of interest.

Disclosures: None.

Author contributions: All authors participated in the conceptualization and writing of this manuscript.

Disclaimer: The views expressed here are those of the authors and do not necessarily represent any official position of the National Cancer Institute, National Institutes of Health, or American Cancer Society.

Prior presentation: A version of this synthesis and conclusion was presented at the 2020 Future of Cancer Health Economics Research virtual conference ( https://healthcaredelivery.cancer.gov/heroic/conference.html ).

Contributor Information

Michael T Halpern, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA.

Joseph Lipscomb, Department of Health Policy and Management, Rollins School of Public Health, and Winship Cancer Institute, Emory University, Atlanta, GA, USA.

K Robin Yabroff, Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA.

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Current UK Practices on Health Economics Analysis Plans (HEAPs): Are We Using Heaps of Them?

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• Volume 36 , pages 253–257, ( 2018 )

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Abbreviations

Clinical trials unit

Health economics analysis plan

Randomised controlled trial

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Acknowledgements

Joanna Thorn acknowledges funding from the MRC ConDuCT-II Hub (Collaboration and innovation for Difficult and Complex randomized controlled Trials in Invasive procedures—MR/K025643/1). The authors would particularly like to thank Professor Will Hollingworth and Dr. Sian Noble for their helpful comments and suggestions. This work was undertaken with the support of the MRC ConDuCT-II Hub (Collaboration and innovation for Difficult and Complex randomized controlled Trials In Invasive procedures—MR/K025643/1), and the MRC Network of Hubs for Trials Methodology Research (MR/L004933/1-N91).

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Dritsaki, M., Gray, A., Petrou, S. et al. Current UK Practices on Health Economics Analysis Plans (HEAPs): Are We Using Heaps of Them?. PharmacoEconomics 36 , 253–257 (2018). https://doi.org/10.1007/s40273-017-0598-x

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