Rosalie Viney is Professor of Health Economics and Director of the Centre for Health Economics Research and Evaluation at the University of Technology Sydney. She has extensive experience in health economics, health services and health policy research. Her research interests include health technology assessment and priority setting, measurement and valuation of quality of life and health outcomes, consumer preferences for health and health care, evaluation of health policy, and the impact of funding arrangements on utilisation and outcomes of health care. Rosalie has undertaken a broad range of commissioned projects for State/Territory Health authorities, and for the Australian Government Department of Health. She is the program leader for the Cancer Australia funded national technical service providing health economics expertise and capacity building to national Cancer Clinical Trials Groups. Rosalie has also had longstanding involvement in the fields of health economics and health services research in Australia, through the Australian Health Economics Society and the Health Services Research Association of Australia and New Zealand. Rosalie is a member of the NHMRC Research Committee. Until March 2017 she was also a member of the Pharmaceutical Benefits Advisory Committee (PBAC) and Chair its Economics Sub-Committee.
Can supervise: YES
Analysis of health insurance, and utilisation of health services, valuation of health outcomes, the use of economic evaluation in resource allocation, and measurement of individual's preferences for health care services.
Arora, S, Goodall, S, Viney, R & Einfeld, S 2019, 'Using discrete choice experiment methods to estimate the value of informal care: the case of children with intellectual disability', PharmacoEconomics, vol. 37, no. 4, pp. 501-511.View/Download from: UTS OPUS or Publisher's site
McTaggart-Cowan, H, King, M, Norman, R, Costa, DSJ, Pickard, AS, Regier, DA, Viney, R & Peacock, SJ 2019, 'The EORTC QLU-C10D: the Canadian valuation study and algorithm to derive cancer-specific utilities from the EORTC QLQ-C30', MDM Policy and Practice.View/Download from: UTS OPUS
Du, W, Gnjidic, D, Pearson, S-A, Hilmer, SN, McLachlan, AJ, Blyth, F, Viney, R, Joshy, G, Day, C & Banks, E 2019, 'Patterns of high-risk prescribing and other factors in relation to receipt of a home medicines review: a prospective cohort investigation among adults aged 45 years and over in Australia.', BMJ open, vol. 9, no. 2, p. e027305.View/Download from: UTS OPUS or Publisher's site
OBJECTIVES:To quantify the relationship between home medicines review (HMR) receipt in older adults and sociodemographic, medication-related and health factors. DESIGN:Prospective cohort analysis. SETTINGS, PARTICIPANTS, MEASUREMENTS:Questionnaire data from a population-based cohort study of individuals aged 45 years, Sydney, Australia were linked with primary healthcare data, medication and hospitalisation data, to ascertain factors associated with HMR receipt during the period July 2009-June 2014. Medication-related factors included exposure to five and more medications (polypharmacy), narrow therapeutic index medicines, potentially inappropriate prescribing defined using Beers Criteria medicines, and anticholinergic and sedative drugs, defined using the Drug Burden Index (DBI). Poisson and Cox regression models were used to evaluate HMR receipt in relation to sociodemographic, behavioural and health characteristics, and time-varying factors including medication use and hospitalisations. PRIMARY OUTCOME:HMR receipt during the 5-year study period. RESULTS:Over 5 years of follow-up, 4.7% (n=6115) of 131483 participants received at least one HMR. Five-year HMR receipt was: 1.5% in people using <5 medications at baseline, 6.8% with 5-9 medications, 12.7% with 10 medications, 8.8% using Narrow Therapeutic Index medicines, 6.8% using Beers Criteria potentially inappropriate medicines and 7.4% using DBI medicines. Age-sex stratified HRs for HMR receipt were 6.07 (95% CI: 5.58 to 6.59) and 12.46 (11.42 to 13.59) for concurrent use of 5-9 and 10versus <5 medications, respectively. The age-sex adjusted rate ratio for HMR receipt was 2.65 (2.51 to 2.80) with poor versus good self-reported health; this association was attenuated substantially following additional adjustment for polypharmacy. CONCLUSIONS:HMR was common in individuals using multiple medications, a formal indication for general practitioner referral and, to a lesser extent, with poorer health and other m...
van der Linden, N, van Gool, K, Gardner, K, Dickinson, H, Agostino, J, Regan, DG, Dowden, M & Viney, R 2019, 'A systematic review of scabies transmission models and data to evaluate the cost-effectiveness of scabies interventions.', PLoS neglected tropical diseases, vol. 13, no. 3, p. e0007182.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:Scabies is a common dermatological condition, affecting more than 130 million people at any time. To evaluate and/or predict the effectiveness and cost-effectiveness of scabies interventions, disease transmission modelling can be used. OBJECTIVE:To review published scabies models and data to inform the design of a comprehensive scabies transmission modelling framework to evaluate the cost-effectiveness of scabies interventions. METHODS:Systematic literature search in PubMed, Medline, Embase, CINAHL, and the Cochrane Library identified scabies studies published since the year 2000. Selected papers included modelling studies and studies on the life cycle of scabies mites, patient quality of life and resource use. Reference lists of reviews were used to identify any papers missed through the search strategy. Strengths and limitations of identified scabies models were evaluated and used to design a modelling framework. Potential model inputs were identified and discussed. FINDINGS:Four scabies models were published: a Markov decision tree, two compartmental models, and an agent-based, network-dependent Monte Carlo model. None of the models specifically addressed crusted scabies, which is associated with high morbidity, mortality, and increased transmission. There is a lack of reliable, comprehensive information about scabies biology and the impact this disease has on patients and society. DISCUSSION:Clinicians and health economists working in the field of scabies are encouraged to use the current review to inform disease transmission modelling and economic evaluations on interventions against scabies.
De Abreu Lourenco, R, Haas, M, Hall, J, Parish, K, Domini, S & Viney, R 2019, 'My mind is made up: cancer concern and women's preferences for contralateral prophylactic mastectomy', European Journal of Cancer Care.View/Download from: UTS OPUS or Publisher's site
Mulhern, B, Norman, R, Street, D & Viney, R 2019, 'One Method, Many Methodological Choices: A Structured Review of Discrete-Choice Experiments for Health State Valuation', PharmacoEconomics, vol. 37, no. 1, pp. 29-43.View/Download from: Publisher's site
Discrete-choice experiments (DCEs) are used in the development of preference-based measure (PBM) value sets. There is considerable variation in the methodological approaches used to elicit preferences.Our objective was to carry out a structured review of DCE methods used for health state valuation.PubMed was searched until 31 May 2018 for published literature using DCEs for health state valuation. Search terms to describe DCEs, the process of valuation and preference-based instruments were developed. English language papers with any study population were included if they used DCEs to develop or directly inform the production of value sets for generic or condition-specific PBMs. Assessment of paper quality was guided by the recently developed Checklist for Reporting Valuation Studies. Data were extracted under six categories: general study information, choice task and study design, type of designed experiment, modelling and analysis methods, results and discussion.The literature search identified 1132 published papers, and 63 papers were included in the review. Paper quality was generally high. The study design and choice task formats varied considerably, and a wide range of modelling methods were employed to estimate value sets.This review of DCE methods used for developing value sets suggests some recurring limitations, areas of consensus and areas where further research is required. Methodological diversity means that the values should be seen as experimental, and users should understand the features of the value sets produced before applying them in decision making.
Reeve, R, Srasuebkul, P, Langton, J, Haas, MR, Viney, R & Pearson, S-A 2018, 'Health care use and costs at the end of life: A comparison of elderly Australian decedents with and without a cancer history', BMC Palliative Care, vol. 17, no. 1, pp. 1-10.View/Download from: UTS OPUS or Publisher's site
There is limited population-level research on end-of-life care in Australia that considers health care use and costs across hospital and community sectors. The aim of this study was to quantify health care use and costs in the last 6 months of life in a cohort of elderly Australian decedents and to examine the factors associated with end-of-life resource use and costs.
A retrospective cohort study using routinely collected health data from Australian Government Department of Veterans' Affairs clients. The study included two cohorts of elderly Australians who died between 2005 and 2009; one cohort with a recorded cancer diagnosis and a comparison cohort with no evidence of a cancer history. We examined hospitalisations, emergency department (ED) visits, prescription drugs, clinician visits, pathology, and procedures and associated costs in the last 6 months of life. We used negative binominal regression to explore factors associated with health service use and costs.
The cancer cohort had significantly higher rates of health service use and 27% higher total health care costs than the comparison cohort; in both cohorts, costs were driven primarily by hospitalisations. Older age was associated with lower costs and those who died in residential aged care incurred half the costs of those who died in hospital.
The results suggest differences in end-of-life care pathways dependent on patient factors, with younger, community-dwelling patients and those with a history of cancer incurring significantly greater costs. There is a need to examine whether the investment in end-of-life care meets patient and societal needs.
Mulhern, B, Norman, R, Shah, K, Bansback, N, Longworth, L & Viney, R 2018, 'How should DCE with duration choice sets be presented for the valuation of health states?', Medical Decision Making, vol. 38, no. 3, pp. 306-318.View/Download from: UTS OPUS or Publisher's site
Background. Discrete Choice Experiments including duration (DCETTO) can be used to generate utility values for health states from measures such as EQ-5D-5L. However, methodological issues concerning the optimum way to present choice sets remain. The aim of the present study was to test a range of task presentation approaches designed to support the DCETTO completion process. Methods. Four separate presentation approaches were developed to examine different task features including dimension level highlighting, and health state severity and duration level presentation. Choice sets included 2 EQ-5D-5L states paired with 1 of 4 duration levels, and a third 'immediate death' option. The same design, including 120 choice sets (developed using optimal methods), was employed across all approaches. The online survey was administered to a sample of the Australian population who completed 20 choice sets across 2 approaches. Conditional logit regression was used to assess model consistency, and scale parameter testing investigated poolability. Results. Overall 1,565 respondents completed the survey. Three approaches, using different dimension level highlighting techniques, produced mainly monotonic coefficients that resulted in a larger disutility as the severity level increased (excepting usual activities levels 2/3). The fourth approach, using a level indicator to present the severity levels, has slightly more non-monotonicity and produced larger ordered differences for the more severe dimension levels. Scale parameter testing suggested that the data cannot be pooled. Conclusions. The results provide information regarding how to present DCE tasks for health state valuation. The findings improve our understanding of the impact of different presentation approaches on valuation, and how DCE questions could be presented to be amenable to completion. However, it is unclear if the task presentation impacts online respondent engagement.
Gamper, E, Kemmler, G, Holzner, B, Norman, R, King, M & Viney, RC 2018, 'Test-retest reliability of discrete choice experiment for valuations of QLU-C10D health states', Value in Health, vol. 21, no. 8, pp. 958-966.View/Download from: Publisher's site
Kasparian, N, De Abreu Lourenco, R, Winlaw, DS, Sholler, DF, Viney, R & Kirk, EPE 2018, 'Tell me once, tell me soon: Parents' preferences for clinical genetics services for congenital heart disease', Genetics in Medicine, vol. 20, no. 11, pp. 1387-1395.View/Download from: UTS OPUS or Publisher's site
Teague, SJ, Newman, LK, Tonge, BJ & Gray, KM 2018, 'Caregiver Mental Health, Parenting Practices, and Perceptions of Child Attachment in Children with Autism Spectrum Disorder', JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS, vol. 48, no. 8, pp. 2642-2652.View/Download from: UTS OPUS or Publisher's site
King, M, Viney, RC, Pickard, S, Rowen, D, Aaronson, NK, Brazier, JE, Cella, D, Costa, DSJ, Fayers, P, Kemmler, G, McTaggart-Cowen, H, Mercieca-Bebber, R, Peacock, S, Street, DJ, Young, TA & Norman, R 2018, 'Australian utility weights for the EORTC QLU-C10D, a multi-attribute utility instrument derived from the cancer-specific quality of life questionnaire, EORTC QLQ-C30', PharmacoEconomics, vol. 36, no. 2, pp. 225-238.View/Download from: UTS OPUS or Publisher's site
The EORTC QLU-C10D is a new multi-attribute utility instrument derived from the widely used cancer-specific quality-of-life (QOL) questionnaire, EORTC QLQ-C30. The QLU-C10D contains ten dimensions (Physical, Role, Social and Emotional Functioning; Pain, Fatigue, Sleep, Appetite, Nausea, Bowel Problems), each with four levels. To be used in cost-utility analysis, country-specific valuation sets are required.
The aim of this study was to provide Australian utility weights for the QLU-C10D.
An Australian online panel was quota-sampled to ensure population representativeness by sex and age ( 18 years). Participants completed a discrete choice experiment (DCE) consisting of 16 choice-pairs. Each pair comprised two QLU-C10D health states plus life expectancy. Data were analysed using conditional logistic regression, parameterised to fit the quality-adjusted life-year framework. Utility weights were calculated as the ratio of each QOL dimension-level coefficient to the coefficient on life expectancy.
A total of 1979 panel members opted in, 1904 (96%) completed at least one choice-pair, and 1846 (93%) completed all 16 choice-pairs. Dimension weights were generally monotonic: poorer levels within each dimension were generally associated with greater utility decrements. The dimensions that impacted most on choice were, in order, Physical Functioning, Pain, Role Functioning and Emotional Functioning. Oncology-relevant dimensions with moderate impact were Nausea and Bowel Problems. Fatigue, Trouble Sleeping and Appetite had relatively small impact. The value of the worst health state was -0.096, somewhat worse than death.
This study provides the first country-specific value set for the QLU-C10D, which can facilitate cost-utility analyses when applied to data collected with the EORTC QLQ-C30, prospectively and retrospectively.
Butow, P, Shaw, J, Shepherd, HL, Price, M, Masya, L, Kelly, B, Rankin, NM, Girgis, A, Hack, TF, Beale, P, Viney, RC, Dhillon, HM, Coll, J, Kelly, P, Lovell, M, Grimison, P, Shaw, T, Luckett, T, Cuddy, J & White, F 2018, 'Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial', BMC Cancer, vol. 18:1077.View/Download from: UTS OPUS or Publisher's site
Cronin, PA, Reeve, R, Viney, R, McCabe, P & Goodall, S 2017, 'The impact of childhood language difficulties on healthcare costs from 4 to 13 years: Australian longitudinal study', International Journal of Speech-Language Pathology, vol. 19, pp. 381-391.View/Download from: UTS OPUS
De Abreu Lourenco, R, Haas, M, Hall, J & Viney, R 2017, 'Valuing meta-health effects for use in economic evaluations to inform reimbursement decisions: a review of the evidence', PharmacoEconomics, vol. 35, no. 3, pp. 347-362.View/Download from: UTS OPUS or Publisher's site
This review explores the evidence from the literature regarding how meta-health effects (effects other than health resulting from the consumption of health care) are valued for use in economic evaluations.
A systematic review of the published literature (the EMBASE, MEDLINE, PsycINFO, CINAHL, EconLit and SocINDEX databases were searched for publications in March 2016, plus manual searching) investigated the associations between study methods and the resulting values for meta-health effects estimated for use in economic evaluations. The review considered which meta-health effects were being valued and how this differed by evaluation approach, intervention investigated, source of funds and year of publication. Detailed reasons for differences observed between values for comparable meta-health effects were explored, accounting for the method of valuation.
The search of the literature revealed 71 studies of interest; 35% involved drug interventions, with convenience, information and process of care the three meta-health effects most often investigated. Key associations with the meta-health effects were the evaluation method, the intervention, and the source of funds. Relative values for meta-health effects ranged from 0.9% to 68% of the overall value reported in a study. For a given meta-health effect, the magnitude of the effect evaluated and how the meta-health effect was described and framed relative to overall health explained the differences in relative values.
Evidence from the literature shows variability in how meta-health effects are being measured for use in economic evaluations. Understanding the sources of that variability is important if decision makers are to have confidence in how meta-health effects are valued.
Mulhern, B, Norman, R, Lorgelly, P, Lancsar, E, Ratcliffe, J, Brazier, J & Viney, R 2017, 'Is Dimension Order Important when Valuing Health States Using Discrete Choice Experiments Including Duration?', PharmacoEconomics, vol. 35, no. 4, pp. 439-451.View/Download from: UTS OPUS or Publisher's site
Nerich, V, Saing, S, Gamper, E-M, Holzner, B, Pivot, X, Viney, R & Kemmler, G 2017, 'Critical appraisal of health-state utility values used in breast cancer-related cost-utility analyses', BREAST CANCER RESEARCH AND TREATMENT, vol. 164, no. 3, pp. 527-536.View/Download from: UTS OPUS or Publisher's site
Pearce, AM, Haas, M, Viney, R, Pearson, S-A, Haywood, P, Brown, C & Ward, R 2017, 'Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study', PLoS ONE, vol. 12, no. 10.View/Download from: UTS OPUS or Publisher's site
Norman, R, Viney, R, Aaronson, NK, Brazier, JE, Cella, D, Costa, DSJ, Fayers, PM, Kemmler, G, Peacock, S, Pickard, AS, Rowen, D, Street, DJ, Velikova, G, Young, TA & King, MT 2017, 'Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format (vol 25, pg 637, 2016)', QUALITY OF LIFE RESEARCH, vol. 26, no. 8, pp. 2247-2248.View/Download from: UTS OPUS or Publisher's site
Fiebig, D, Viney, RC, Knox, S, Haas, M, Street, D, Hole, AR, Weisberg, E & Bateson, D 2017, 'Consideration sets and their role in modelling doctor recommendations about contraceptives', Health Economics, vol. 26, no. 1, pp. 54-73.View/Download from: UTS OPUS or Publisher's site
Decisions about prescribed contraception are typically the result of a consultation between a woman and her doctor. In order to better understand contraceptive choice within this environment, stated preference methods are utilized to ask doctors about what contraceptive options they would discuss with different types of women. The role of doctors is to confine their discussion to a subset of products that best match their patient. This subset of options forms the consideration set from which the ultimate recommendation is made. Given the existence of consideration sets we address the issue of how to model appropriately the ultimate recommendations. The estimated models enable us to characterize doctor recommendations and how they vary with patient attributes and to highlight where recommendations are clear and when they are uncertain. The results also indicate systematic variation in recommendations across different types of doctors, and in particular we observe that some doctors are reluctant to embrace new products and instead recommend those that are more familiar. Such effects are one possible explanation for the relatively low uptake of more cost effective longer acting reversible contraceptives and indicate that further education and training of doctors may be warranted. Copyright © 2015 John Wiley & Sons, Ltd.
King, MT, Costa, DSJ, Aaronson, NK, Brazier, JE, Cella, DF, Fayers, PM, Grimison, P, Janda, M, Kemmler, G, Norman, R, Pickard, AS, Rowen, D, Velikova, G, Young, TA & Viney, R 2016, 'QLU-C10D: a health state classification system for a multi-attribute utility measure based on the EORTC QLQ-C30 (vol 25, pg 625, 2016)', QUALITY OF LIFE RESEARCH, vol. 25, no. 10, pp. 2683-2683.View/Download from: Publisher's site
Reeve, R, Arora, S, Butler, K, Viney, R, Burns, L, Goodall, S & van Gool, K 2016, 'Evaluating the impact of hospital based drug and alcohol consultation liaison services', Journal of Substance Abuse Treatment, vol. 68, pp. 36-45.View/Download from: UTS OPUS or Publisher's site
Butler, K, Reeve, R, Viney, R & Burns, L 2016, 'Estimating prevalence of drug and alcohol presentations to hospital emergency departments in NSW, Australia: Impact of hospital consultation liaison services', Public Health Research and Practice, vol. 26, no. 4.View/Download from: Publisher's site
© 2016 Butler et al. The impact of drug and alcohol misuse has been the subject of widespread media discussion in the past year, particularly in the context of restricted alcohol trading hours in an effort to reduce alcohol-fuelled violence. A recent study evaluating NSW Health's drug and alcohol consultation liaison (CL) services1 demonstrates how pervasive drug and alcohol problems are, and the impact they have on the health system. This paper highlights how expanding CL services to fill current unmet need could deliver a range of benefits to patients and hospitals.
Norman, R, Kemmler, G, Viney, R, Pickard, AS, Gamper, E, Holzner, B, Nerich, V & King, M 2016, 'Order of Presentation of Dimensions Does Not Systematically Bias Utility Weights from a Discrete Choice Experiment', Value in Health, vol. 19, no. 8, pp. 1033-1038.View/Download from: Publisher's site
© 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).Background: Discrete choice experiments (DCEs) are increasingly used to value aspects of health. An issue with their adoption is that results may be sensitive to the order in which dimensions of health are presented in the valuation task. Findings in the literature regarding order effects are discordant at present. Objectives: To quantify the magnitude of order effect of quality-of-life (QOL) dimensions within the context of a DCE designed to produce country-specific value sets for the EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D), a new utility instrument derived from the widely used cancer-specific QOL questionnaire, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. Methods: The DCE comprised 960 choice sets, divided into 60 versions of 16 choice sets, with each respondent assigned to a version. Within each version, the order of QLU-C10D QOL dimensions was randomized, followed by life duration in the last position. The DCE was completed online by 2053 individuals in France and Germany. We analyzed the data with a series of conditional logit models, adjusted for repeated choices within respondent. We used . F tests to assess order effects, correcting for multiple hypothesis testing. Results: Each . F test failed to reject the null hypothesis of no position effect: 1) all QOL order positions considered jointly; 2) last QOL position only; 3) first QOL position only. Furthermore, the order coefficients were small relative to those of the QLU-C10D QOL dimension levels. Conclusions: The order of presentation of QOL dimensions within a DCE designed to provide utility weights for the QLU-C10D had little effect on level coefficients of those QOL dimensions.
Mulhern, B, Norman, R, Viney, R & Stolk, E 2016, 'USING DISCRETE CHOICE EXPERIMENTS TO VALUE GENERIC PREFERENCE-BASED MEASURES: A SYSTEMATIC REVIEW', VALUE IN HEALTH, vol. 19, no. 3, pp. A95-A96.View/Download from: Publisher's site
Mulhern, B, Norman, R, Viney, R, Lorgelly, P, Lancsar, E, Ratcliffe, J & Brazier, J 2016, 'Valuing EQ-5D-5L using discrete choice experiments with duration: Investigating dimension order', Value in Health, vol. 19, no. 3, pp. A94-A94.
Hole, AR, Norman, R & Viney, R 2016, 'Response patterns in health state valuation using endogenous attribute attendance and latent class analysis', Health economics, vol. 25, no. 2, pp. 212-224.View/Download from: UTS OPUS or Publisher's site
Not accounting for simplifying decision-making heuristics when modelling data from discrete choice experiments has been shown potentially to lead to biased inferences. This study considers two ways of exploring the presence of attribute non-attendance (that is, respondents considering only a subset of the attributes that define the choice options) in a health state valuation discrete choice experiment. The methods used include the latent class (LC) and endogenous attribute attendance (EAA) models, which both required adjustment to reflect the structure of the quality-adjusted life year (QALY) framework for valuing health outcomes. We find that explicit consideration of attendance patterns substantially improves model fit. The impact of allowing for non-attendance on the estimated QALY weights is dependent on the assumed source of non-attendance. If non-attendance is interpreted as a form of preference heterogeneity, then the inferences from the LC and EAA models are similar to those from standard models, while if respondents ignore attributes to simplify the choice task, the QALY weights differ from those using the standard approach. Because the cause of non-attendance is unknown in the absence of additional data, a policymaker may use the range of weights implied by the two approaches to conduct a sensitivity analysis. Copyright © 2014 John Wiley & Sons, Ltd.
Butler, K, Reeve, R, Arora, S, Viney, R, Goodall, S, van Gool, K & Burns, L 2016, 'The hidden costs of drug and alcohol use in hospital emergency departments', Drug and Alcohol Review, vol. 35, no. 3, pp. 359-366.View/Download from: UTS OPUS or Publisher's site
King, MT, Costa, DS, Aaronson, NK, Brazier, JE, Cella, D, Fayers, PM, Grimison, P, Janda, M, Kemmler, G, Norman, R, Pickard, AS, Rowan, D, Velikova, G, Young, TA & Viney, RC 2016, 'QLU-C10D: a health state classification system for a multi-attribute utility measure based on the EORTC QLQ-C30', Quality of Life Research, vol. 25, no. 3, pp. 625-636.View/Download from: Publisher's site
Norman, R, Mulhern, BJ & Viney, R 2016, 'The impact of different DCE-based approaches when anchoring utility scores', PharmacoEconomics, vol. 34, no. 8, pp. 805-814.View/Download from: UTS OPUS or Publisher's site
Parkinson, B, Viney, RC, Haas, M, Goodall, S, Srasuebkul, P & Pearson, SA 2016, 'Real world evidence: a comparison of the Australian Herceptin Program and clinical trials of trastuzumab for HER2+ metastatic breast cancer', PharmacoEconomics, vol. 34, no. 10, pp. 1039-1050.View/Download from: UTS OPUS or Publisher's site
Norman, R, Viney, RC, Aaronson, NK, Brazier, JE, Cella, D, Costa, DS, Fayers, PM, Kemmler, G, Peacock, S, Pickard, AS, Rowen, D, Street, DJ, Velikova, G, Young, TA & King, MT 2016, 'Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format', Quality of Life Research, vol. 25, no. 3, pp. 637-649.View/Download from: UTS OPUS or Publisher's site
To assess the feasibility of using a discrete choice experiment (DCE) to value health states within the QLU-C10D, a utility instrument derived from the QLQ-C30, and to assess clarity, difficulty, and respondent preference between two presentation formats.
We ran a DCE valuation task in an online panel (N = 430). Respondents answered 16 choice pairs; in half of these, differences between dimensions were highlighted, and in the remainder, common dimensions were described in text and differing attributes were tabulated. To simplify the cognitive task, only four of the QLU-C10D's ten dimensions differed per choice set. We assessed difficulty and clarity of the valuation task with Likert-type scales, and respondents were asked which format they preferred. We analysed the DCE data by format with a conditional logit model and used Chi-squared tests to compare other responses by format. Semi-structured telephone interviews (N = 8) explored respondents' cognitive approaches to the valuation task.
Four hundred and forty-nine individuals were recruited, 430 completed at least one choice set, and 422/449 (94 %) completed all 16 choice sets. Interviews revealed that respondents found ten domains difficult but manageable, many adopting simplifying heuristics. Results for clarity and difficulty were identical between formats, but the 'highlight' format was preferred by 68 % of respondents. Conditional logit parameter estimates were monotonic within domains, suggesting respondents were able to complete the DCE sensibly, yielding valid results.
A DCE valuation task in which only four of the QLU-C10D's ten dimensions differed in any choice set is feasible for deriving utility weights for the QLU-C10D.
Norman, R, Viney, R, Aaronson, NK, Brazier, JE, Cella, D, Costa, DSJ, Fayers, PM, Kemmler, G, Peacock, S, Pickard, AS, Rowen, D, Street, DJ, Velikova, G, Young, TA & King, MT 2016, 'Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format (vol 25, pg 637, 2016)', QUALITY OF LIFE RESEARCH, vol. 25, no. 9, pp. 2401-2401.View/Download from: Publisher's site
Anazodo, A, Gerstl, B, Sullivan, E, Ledger, W, Orme, L, Stern, K, Viney, RC, Gillam, L, Jetti, M, Mclachlan, R, Jayasinghe, Y, Cohn, R, Wakefield, C, Dean, R, Agresta, F, Vu, J, Daly, E, Chan, D, Chapman, M, Kemertzis, M, Wand, H & Gilbert, L 2016, 'A Study Protocol for the Australasian Oncofertility Registry: Monitoring referral patterns and the uptake, quality and complications of fertility preservation strategies in Australia and New Zealand', Journal of Adolescent and Young Adult Oncology, vol. 5, no. 3, pp. 215-225.View/Download from: UTS OPUS or Publisher's site
Improvements in cancer diagnosis and treatment in patients of a reproductive age have led to significant improvements in survival rates; however, a patient's fertility can be affected by both cancer and its treatment. As survival rates improve, there is an expectation by clinicians and patients that patient's reproductive potential should be considered and protected as much as possible. However, there is a lack of data about current fertility preservation (FP) uptake as well as accurate data on the acute or permanent reproductive risks of cancer treatment, complications of FP in cancer patients, and the use and success of assisted reproductive technology by cancer survivors. FP remains a major gap in acute cancer management with lifelong implications for cancer survivors. The FUTuRE Fertility research team has established the first binational multisite Australasian Oncofertility Registry, which is collecting a complete oncofertility data set from cancer and fertility centers in Australia and New Zealand. Outcomes from the research study will monitor referral, uptake, and complications of FP, document patient's reproductive potential after treatment, and collect data on the use of assisted reproductive technology following cancer treatment. The data will be linked to other routine health and administrative data sets to allow for other research projects to be carried out. The changes in oncofertility care will be benchmarked against the Australasian Oncofertility Charter. The data will be used to develop evidence-based guidelines and resources, including development of accurate risk projections for patients' risk of infertility, allowing clinicians to make recommendations for FP or assisted reproductive technology.
Langton, J, Reeve, R, Srasuebkul, P, Haas, M, Viney, R, Currow, D & Pearson, S-A 2016, 'Health service use and costs in the last six months of life in elderly decedents with a history of cancer: A comprehensive analysis from a health payer perspective', British Journal of Cancer, vol. 114, no. 11, pp. 1293-1302.View/Download from: Publisher's site
Scarf, V, Catling, C, Viney, R & Homer, CS 2016, 'Costing alternative birth settings for women at low risk of complications: A systematic review', PLoS One, vol. 11, no. 2, pp. 1-17.View/Download from: UTS OPUS or Publisher's site
There is demand from women for alternatives to giving birth in a standard hospital setting however access to these services is limited. This systematic review examines the literature relating to the economic evaluations of birth setting for women at low risk of complications.
Searches of the literature to identify economic evaluations of different birth settings of the following electronic databases: MEDLINE, CINAHL, EconLit, Business Source Complete and Maternity and Infant care. Relevant English language publications were chosen using keywords and MeSH terms between 1995 and 2015. Inclusion criteria included studies focussing on the comparison of birth setting. Data were extracted with respect to study design, perspective, PICO principles, and resource use and cost data.
Eleven studies were included from Australia, Canada, the Netherlands, Norway, the USA, and the UK. Four studies compared costs between homebirth and the hospital setting and the remaining seven focussed on the cost of birth centre care and the hospital setting. Six studies used a cost-effectiveness analysis and the remaining five studies used cost analysis and cost comparison methods. Eight of the 11 studies found a cost saving in the alternative settings. Two found no difference in the cost of the alternative settings and one found an increase in birth centre care.
There are few studies that compare the cost of birth setting. The variation in the results may be attributable to the cost data collection processes, difference in health systems and differences in which costs were included. A better understanding of the cost of birth setting is needed to inform policy makers and service providers.
Pearce, A, Haas, M, Viney, R, Haywood, P, Pearson, S-A, van Gool, K, Srasuebkul, P & Ward, R 2015, 'Can administrative data be used to measure chemotherapy side effects?', EXPERT REVIEW OF PHARMACOECONOMICS & OUTCOMES RESEARCH, vol. 15, no. 2, pp. 215-222.View/Download from: Publisher's site
Langton, JM, Srasuebkul, P, Reeve, R, Parkinson, B, Gu, Y, Buckley, NA, Haas, M, Viney, R, Pearson, SA & The End-of-Life in Cancer Care (EoL-CC) Investigators 2015, 'Resource use, costs and quality of end-of-life care: observations in a cohort of elderly Australian cancer decedents.', Implementation Science, vol. 10, no. 25, pp. 1-14.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The last year of life is one of the most resource-intensive periods for people with cancer. Very little population-based research has been conducted on end-of-life cancer care in the Australian health care setting. The objective of this program is to undertake a series of observational studies examining resource use, costs and quality of end-of-life care in a cohort of elderly cancer decedents using linked, routinely collected data. METHODS/DESIGN: This study forms part of an ongoing cancer health services research program. The cohorts for the end-of-life research program comprise Australian Government Department of Veterans' Affairs decedents with full health care entitlements, residing in NSW for the last 18 months of life and dying between 2005 and 2009. We used cancer and death registry data to identify our decedent cohorts and their causes of death. The study population includes 9,862 decedents with a cancer history and 15,483 decedents without a cancer history. The median age at death is 86 and 87 years in the cancer and non-cancer cohorts, respectively. We will examine resource use and associated costs in the last 6 months of life using linked claims data to report on health service use, hospitalizations, emergency department visits and medicines use. We will use best practice methods to examine the nature and extent of resource use, costs and quality of care based on previously published indicators. We will also examine factors associated with these outcomes. DISCUSSION: This will be the first Australian research program and among the first internationally to combine routinely collected data from primary care and hospital-based care to examine comprehensively end-of-life care in the elderly. The research program has high translational value, as there is limited evidence about the nature and quality of care in the Australian end-of-life setting.
Luxford, K, Axam, A, Hasnip, F, Dobrohotoff, J, Strudwick, M, Reeve, R, Hou, C & Viney, RC 2015, 'Improving clinician-carer communication for safer hospital care: a study of the 'TOP 5' strategy in patients with dementia', International Journal for Quality in Health Care, vol. 27, no. 3, pp. 175-182.View/Download from: UTS OPUS or Publisher's site
To examine the impact of implementing a clinician–carer communication tool for hospitalized patients with dementia.
Surveys were conducted with clinicians and carers about perceptions and experiences. Implementation process and costs were explored through surveys of local staff. Time series analysis was conducted on incident-reported falls, usage of non-regular anti-psychotics and one-to-one nursing.
Twenty-one hospitals in Australia.
Surveys were returned by 798 clinicians, 240 carers and 21 local liaison staff involved in implementation.
Implementation of a communication tool over 12 months.
Main outcome measures
The process of implementation was documented. Outcome measures included clinician and carer perceptions, safety indicators (incident-reported falls and usage of non-regular anti-psychotics), resource use and costs.
Clinicians and carers reported high levels of acceptability and perceived benefits for patients. Clinicians rated confidence in caring for patients with dementia as being significantly higher after the introduction of TOP 5, (M = 2.93, SD = 0.65), than prior to TOP 5 (M = 2.74, SD = 0.75); F(1,712) = 11.21, P < 0.05. When analysed together, there was no change in incident-reported falls across all hospitals. At one hospital with a matched control ward, an average of 6.85 fewer falls incidents per month occurred in the intervention ward compared with the matched control ward (B = 6.85, P < 0.05).
Our findings indicate that the use of a simple, low-cost communication strategy for patient care is associated with improvements in clinician and carer experience with potential implications for patient safety. Minimally, TOP 5 represents 'good practice' with a low risk of harm for patients.
Xie, F, Pickard, S, Krabbe, P, Revicki, D, Viney, R, Devlin, N & Feeny, D 2015, 'A checklist for reporting valuation studies of multi-attribute utility-based instruments (CREATE)', PharmacoEconomics, vol. 33, no. 8, pp. 867-877.View/Download from: Publisher's site
Parkinson, BT, Sermet, C, Clement, F, Crausaz, S, Godman, B, Garner, S, Choudhury, M, Pearson, S-A, Viney, R & Lopert, R 2015, 'Disinvestment and value-based purchasing strategies for pharmaceuticals: An international review', PharmacoEconomics, vol. 33, pp. 905-924.View/Download from: Publisher's site
Hou, C, Siva, S, Haas, M & Viney, R 2014, 'COST-EFFECTIVENESS OF POST-THERAPY PET AND TELEPHONE INTERVIEW IN THE CLINICAL FOLLOW-UP OF PATIENTS TREATED WITH LOCALLY ADVANCED CERVICAL CANCER.', Value in Health, vol. 17, no. 7, pp. A736-A737.View/Download from: UTS OPUS
Our previous research indicated that post-therapy PET scanning may obviate the need for hospital-based follow-up in patients with locally advanced cervical cancer who achieved a complete metabolic response (CMR). In these patients, asymptomatic recurrences were rarely discovered through examination in the clinic. The aim of this research is to evaluate the cost-effectiveness of applying different follow-up strategies in Australia.
A decision analytical model was constructed to evaluate cost per quality-adjusted life-year (QALY) and life-years gained (LYG) by comparing two follow-up strategies: 1) Routine hospital-based follow-up and 2) Alternative follow-up involving post-therapy PET and nurse-led telephone interview. A model was built using data from a prospective institutional registry study of 105 consecutive women underwent definitive chemoradiation therapy. Based on published institutional data, it was estimated that patients who had a complete metabolic response identified by PET, would have 5-year overall-survival of 93% and 1.5% recurrence rate, while those without CMR would have a 5-year overall-survival of only 36%.The impact of uncertainty was evaluated using probabilistic sensitivity analysis.
Costs for Alternative follow-up was estimated to be $25,657 compared with $19,982 for Routine follow-up. Alternative follow-up is not cost-saving; this is because the cost of PET screening and additional treatment performed on those without CMR is more than offset by the cost of intensive hospital-based visits avoided. Preliminary modeling suggest that the Alternative follow-up is likely to be cost-effective compared with Routine follow-up with an ICER of $4,094/QALYs gained, given the survival benefit associated with better targeted salvage therapy and that this result is robust to a range of survival gain estimates and other parameters.
Performing PET scan to evaluate patient's risk of recurrence is an appealing prosp...
Costa, D, Aaronson, N, Fayers, P, Grimison, P, Janda, M, Pallant, J, Rowen, D, Velikova, G, Viney, R, Young, T & King, M 2014, 'Deriving a preference-based utility measure for cancer patients from the European Organisation for the Research and Treatment of Cancer's Quality of Life Questionnaire C30: a confirmatory versus exploratory approach', Patient Related Outcome Measures, vol. 5, pp. 119-129.View/Download from: UTS OPUS or Publisher's site
Background: Multi attribute utility instruments (MAUIs) are preference-based measures that comprise a health state classification system (HSCS) and a scoring algorithm that assigns a utility value to each health state in the HSCS. When developing a MAUI from a health-related quality of life (HRQOL) questionnaire, first a HSCS must be derived. This typically involves selecting a subset of domains and items because HRQOL questionnaires typically have too many items to be amendable to the valuation task required to develop the scoring algorithm for a MAUI. Currently, exploratory factor analysis (EFA) followed by Rasch analysis is recommended for deriving a MAUI from a HRQOL measure.
Aim: To determine whether confirmatory factor analysis (CFA) is more appropriate and efficient than EFA to derive a HSCS from the European Organisation for the Research and Treatment of Cancer's core HRQOL questionnaire, Quality of Life Questionnaire (QLQ-C30), given its well-established domain structure.
Methods: QLQ-C30 (Version 3) data were collected from 356 patients receiving palliative radiotherapy for recurrent/metastatic cancer (various primary sites). The dimensional structure of the QLQ-C30 was tested with EFA and CFA, the latter informed by the established QLQ-C30 structure and views of both patients and clinicians on which are the most relevant items. Dimensions determined by EFA or CFA were then subjected to Rasch analysis.
Results: CFA results generally supported the proposed QLQ-C30 structure (comparative fit index =0.99, Tucker–Lewis index =0.99, root mean square error of approximation =0.04). EFA revealed fewer factors and some items cross-loaded on multiple factors. Further assessment of dimensionality with Rasch analysis allowed better alignment of the EFA dimensions with those detected by CFA.
Conclusion: CFA was more appropriate and efficient than EFA in producing clinically interpretable results for the HSCS for a proposed new cancer-specific MAUI. Our findings sugg...
Lopert, R & Viney, R 2014, 'Revolution then evolution: The advance of health economic evaluation in Australia', Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, vol. 108, no. 7, pp. 360-366.View/Download from: Publisher's site
Girgis, A, Kelly, B, Boyes, A, Haas, M, Viney, R, Descallar, J, Candler, H, Bellamy, D & Proietto, A 2014, 'The PACT study protocol: a time series study investigating the impact, acceptability and cost of an integrated model for psychosocial screening, care and treatment of patients with urological and head and neck cancers.', BMJ Open, vol. 4, no. 1, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
INTRODUCTION: While there is good evidence of the effectiveness of a variety of interventions and services to prevent and/or relieve distress experienced by people affected by cancer, much of this psychosocial morbidity is undetected and untreated, with consequent exacerbated suffering, decreased satisfaction with care, impaired adherence to treatment regimens and poorer morbidity and mortality outcomes. The objective of this study is to develop, implement and assess the impact, acceptability and cost of an integrated, patient-centred Psychosocial Assessment, Care and Treatment (PACT) model of care for patients with urological and head and neck cancers. METHODS AND ANALYSIS: A time series research design will be used to test the PACT model of care, newly introduced in an Australian tertiary hospital. The primary outcome is system-level impact, assessed through audit of patients' medical records and Medicare claims for follow-up care. The secondary outcomes are impact of the model on patients' experience and healthcare professionals' (HCPs) knowledge and confidence, assessed via patient and HCP surveys at baseline and at follow-up. Acceptability of the intervention will be assessed through HCP interviews at follow-up, and cost will be assessed from Medicare and Pharmaceutical Benefits Scheme claims information and information logged pertaining to intervention activities (eg, time spent by the newly appointed psycho-oncology staff in direct patient contact, providing training sessions, engaging in case review) and their associated costs (eg, salaries, training materials and videoconferencing). ETHICS AND DISSEMINATION: Ethics approval was obtained from the Human Research Ethics Committees of Hunter New England Local Health District and the University of NSW. RESULTS: The results will be widely disseminated to the funding body and through peer-reviewed publications, HCP and consumer publications, oncology conferences and meetings. TRIAL REGISTRATION: The study is re...
Parkinson, BT, Pearson, S & Viney, RC 2014, 'Economic evaluations of Trastuzumab in HER2 positive metastatic breast cancer: a systematic review and critique', European Journal of Health Economics, vol. 15, no. 1, pp. 93-112.View/Download from: Publisher's site
BACKGROUND: Published economic evaluations of trastuzumab for the treatment of HER2-positive metastatic breast cancer have arrived at different conclusions regarding the cost-effectiveness of trastuzumab, despite comparative efficacy being demonstrated by a small set of randomised controlled trials (RCTs). OBJECTIVES: This article aims to provide insight into the quality of the evaluations and explore the possible drivers of the conflicting conclusions. METHODS: A systematic literature review was conducted to identify all published economic evaluations that compared the incremental costs and outcomes of trastuzumab versus a comparator. RESULTS: Fifteen economic evaluations were identified. In the evaluations that estimated efficacy using an RCT, the key drivers of the conclusions regarding cost-effectiveness were: the approach used to estimate overall survival in the control group given crossover to trastuzumab following progression in the trials; the inclusion of treatment beyond progression; inclusion of wastage due to unused vial portions, adverse events, and the cost of HER2 testing. Four evaluations used non-randomised approaches to estimate efficacy, thus introducing the potential for confounding. As a result these evaluations reported relatively optimistic estimates of comparative effectiveness. Finally the evaluations used different thresholds to determine whether treatment with trastuzumab was cost-effective. CONCLUSION: There were numerous drivers of the different conclusions regarding the cost-effectiveness of trastuzumab, many of which are due to judgements made by the authors when translating data from RCTs. Many of the potential drivers were not identified by the published systematic reviews of economic evaluations and perhaps more remain unidentified because of inconsistent and limited reporting
Reeve, RD, Church, J, Haas, MR, Bradford, W & Viney, RC 2014, 'Factors that drive the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW?', Australian and New Zealand Journal of Public Health, vol. 38, no. 5, pp. 459-465.View/Download from: Publisher's site
Objective: To identify factors underpinning the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW. This will indicate appropriate target areas for policy and for monitoring progress towards reducing the gap. Methods: Data from the 200405 National Health Survey and National Aboriginal and Torres Strait Islander Health Survey were used to estimate differences in self-reported diabetes rates and risk/prevention factors between Aboriginal and non-Aboriginal people in non-remote NSW. Logistic regression models were used to investigate the contribution of each factor to predicting the probability of diabetes. Results: Risk factors for diabetes are more prevalent and diabetes rates 2.5 to 4 times higher in Aboriginal compared to non-Aboriginal adults in non-remote NSW. The odds of (known) diabetes for both groups are significantly higher for older people, those with low levels of education and those who are overweight or obese. In the Aboriginal sample, the odds of diabetes are significantly higher for people reporting forced removal of their relatives. Conclusions: Differences in BMI and education appear to be driving the diabetes gap, together with onset at younger ages in the Aboriginal population. Psychological distress, indicated by removal of relatives, may contribute to increased risk of diabetes in the Aboriginal population. Implications: The results imply that improved nutrition and exercise, capacity to access and act upon health care information and early intervention are required to reduce the diabetes gap. Current strategies appear to be appropriately aligned with the evidence; however, further research is required to determine whether implementation methods are effective.
Gu, Y, Norman, R & Viney, RC 2014, 'Estimating health state utility values from discrete choice experiments: a QALY space model approach', Health Economics, vol. 23, no. 9, pp. 1098-1114.View/Download from: UTS OPUS or Publisher's site
Using discrete choice experiments (DCEs) to estimate health state utility values has become an important alternative to the conventional methods of Time Trade-Off and Standard Gamble. Studies using DCEs have typically used the conditional logit to estimate the underlying utility function. The conditional logit is known for several limitations. In this paper, we propose two types of models based on the mixed logit: one using preference space and the other using quality-adjusted life year (QALY) space, a concept adapted from the willingness-to-pay literature. These methods are applied to a dataset collected using the EQ-5D. The results showcase the advantages of using QALY space and demonstrate that the preferred QALY spacemodel provides lower estimates of the utility values than the conditional logit, with the divergence increasing with worsening health states.
Whitehurst, D, Norman, R, Brazier, JE & Viney, RC 2014, 'Comparison of contemporaneous EQ-5D and SF-6D responses using published scoring algorithms derived from similar valuation exercises', Value in Health, vol. 17, pp. 570-577.View/Download from: Publisher's site
Objectives Poor agreement between preference-based health-related quality-of-life instruments has been widely reported across patient and community-based samples. This study compares index scores generated from contemporaneous EQ-5D (3-level version) and SF-6D (SF-36 version) responses using scoring algorithms derived from independently-conducted Australian population-representative discrete choice experiments (DCEs), providing the first comparative analysis of health state valuations using the same method of valuation across the full value sets. Methods EQ-5D and SF-6D responses from seven patient data sets were transformed into health state valuations using published DCE-derived scoring algorithms. The empirical comparative evaluation consisted of graphical illustration of the location and spread of index scores, reporting of basic descriptive statistics, exploration of between-measure differences in mean index scores, and analysis of agreement. Results Compared with previously published findings regarding the comparability of "conventional" EQ-5D and SF-6D index scores, health state valuations from the DCE-derived scoring procedures showed that agreement between scores remained "fair" (intraclass correlation coefficient values across the seven data sets ranged from 0.375 to 0.615). Mean SF-6D scores were significantly lower than the respective mean EQ-5D score across all patient groups (mean difference for the whole sample = 0.253). Conclusions The magnitude of disagreement previously reported between EQ-5D and SF-6D index scores is not ameliorated through the application of DCE-derived value sets; sizeable discrepancies remain. These findings suggest that differences between EQ-5D and SF-6D index scores persist because of their respective descriptive systems. Further research is required to explore the implications of variations in the descriptive systems of preference-based instruments.
Norman, R, Viney, RC, Brazier, JE, Burgess, LB, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2014, 'Valuing SF-6D health states using a Discrete Choice Experiment', Medical Decision Making, vol. 34, no. 6, pp. 773-786.View/Download from: Publisher's site
Background. SF-6D utility weights are conventionally produced using a standard gamble (SG). SG-derived weights consistently demonstrate a floor effect not observed with other elicitation techniques. Recent advances in discrete choice methods have allowed estimation of utility weights. The objective was to produce Australian utility weights for the SF-6D and to explore the application of discrete choice experiment (DCE) methods in this context. We hypothesized that weights derived using this method would reflect the largely monotonic construction of the SF-6D. Methods. We designed an online DCE and administered it to an Australia-representative online panel (n = 1017). A range of specifications investigating nonlinear preferences with respect to additional life expectancy were estimated using a random-effects probit model. The preferred model was then used to estimate a preference index such that full health and death were valued at 1 and 0, respectively, to provide an algorithm for Australian cost-utility analyses. Results. Physical functioning, pain, mental health, and vitality were the largest drivers of utility weights. Combining levels to remove illogical orderings did not lead to a poorer model fit. Relative to international SG-derived weights, the range of utility weights was larger with 5% of health states valued below zero. Conclusions. DCEs can be used to investigate preferences for health profiles and to estimate utility weights for multi-attribute utility instruments. Australian cost-utility analyses can now use domestic SF-6D weights. The comparability of DCE results to those using other elicitation methods for estimating utility weights for quality-adjusted life-year calculations should be further investigated.
Viney, RC, Norman, R, Brazier, JE, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2014, 'An Australian discrete choice experiment to value EQ-5D health states', Health Economics, vol. 23, no. 6, pp. 729-742.View/Download from: UTS OPUS or Publisher's site
Conventionally, generic quality-of-life health states, defined within multi-attribute utility instruments, have been valued using a Standard Gamble or a Time Trade-Off. Both are grounded in expected utility theory but impose strong assumptions about the form of the utility function. Preference elicitation tasks for both are complicated, limiting the number of health states that each respondent can value and, therefore, that can be valued overall. The usual approach has been to value a set of the possible health states and impute values for the remainder. Discrete Choice Experiments (DCEs) offer an attractive alternative, allowing investigation of more flexible specifications of the utility function and greater coverage of the response surface. We designed a DCE to obtain values for EQ-5D health states and implemented it in an Australia-representative online panel (n?=?1,031). A range of specifications investigating non-linear preferences with respect to time and interactions between EQ-5D levels were estimated using a random-effects probit model. The results provide empirical support for a flexible utility function, including at least some two-factor interactions. We then constructed a preference index such that full health and death were valued at 1 and 0, respectively, to provide a DCE-based algorithm for Australian cost-utility analyses.
Johar, M, Fiebig, DG, Haas, MR & Viney, RC 2013, 'Using repeated choice experiments to evaluate the impact of policy changes on cervical screening', Applied Economics, vol. 45, no. 14, pp. 1845-1855.View/Download from: UTS OPUS or Publisher's site
Australia was one of the first countries to introduce a publicly funded Human Papilloma Virus (HPV) vaccine program, and its introduction coincided with a media campaign to promote regular cervical screening. One issue with HPV vaccination is how it impacts on demand for screening. This study examines changes in women's screening preferences following these two interventions, using a novel approach to policy evaluation based on repeated discrete choice experiments. The study extends our previous analysis of attitudes to screening by taking advantage of the timing of the choice experiments to examine the impact of the two policy changes on determinants of screening. We find that, unexpectedly, willingness to screen is generally lower post-interventions. The reason for this trend appears to be related to HPV vaccination. We also find that interventions have minor impacts on how women value screening attributes. Our approach allows us to examine the impact of provider behaviour. A simulation demonstrates that under certain conditions, participation rates can be increased by 40% to 50% if health providers actively encourage women to undertake a cervical screening test.
Gnjidic, D, Le Couteur, DG, Pearson, S, McLachlan, A, Viney, RC, Hilmer, SN, Blyth, FM, Joshy, G & Banks, E 2013, 'High risk prescribing in older adults: Prevalence, clinical and economic implications and potential for intervention at the population level', BMC Public Health, vol. 13, no. 115, pp. 1-9.View/Download from: UTS OPUS or Publisher's site
Background High risk prescribing can compromise independent wellbeing and quality of life in older adults. The aims of this project are to determine the prevalence, risk factors, clinical consequences, and costs of high risk prescribing, and to assess the impact of interventions on high risk prescribing in older people. Methods The proposed project will utilise data from the 45 and Up Study, a large scale cohort of 267,153 men and women aged 45 and over recruited during 20062009 from the state of New South Wales, Australia linked to a range of administrative health datasets. High risk prescribing will be assessed using three indicators: polypharmacy (use of five or more medicines); Beers Criteria (an explicit measure of potentially inappropriate medication use); and Drug Burden Index (a pharmacologic dose-dependent measure of cumulative exposure to anticholinergic and sedative medicines). Individual risk factors from the 45 and Up Study questionnaire, and health system characteristics from health datasets that are associated with the likelihood of high risk prescribing will be identified. The main outcome measures will include hospitalisation (first admission to hospital, total days in hospital, cause-specific hospitalisation); admission to institutionalised care; all-cause mortality, and, where possible, cause-specific mortality. Economic costs to the health care system and implications of high risk prescribing will be also investigated. In addition, changes in high risk prescribing will be evaluated in relation to certain routine medicines-related interventions. The statistical analysis will be conducted using standard pharmaco-epidemiological methods including descriptive analysis, univariate and multivariate regression analysis, controlling for relevant confounding factors, using a number of different approaches.
Pearce, AM, Haas, MR & Viney, RC 2013, 'Are the true impacts of adverse events considered in economic models of antineoplastic drugs? A systematic review', Applied Health Economics and Health Policy, vol. 11, no. 6, pp. 619-637.View/Download from: UTS OPUS or Publisher's site
Background Antineoplastic drugs for cancer are often associated with adverse events, which influence patients' physical health, quality of life and survival. However, the modelling of adverse events in cost-effectiveness analyses of antineoplastic drugs has not been examined. Aims This article reviews published economic evaluations that include a calculated cost for adverse events of antineoplastic drugs. The aim is to identify how existing models manage four issues specific to antineoplastic drug adverse events: the selection of adverse events for inclusion in models, the influence of dose modifications on drug quantity and survival outcomes, the influence of adverse events on quality of life and the consideration of multiple simultaneous or recurring adverse events. Methods A systematic literature search was conducted using MESH headings and key words in multiple electronic databases, covering the years 19992009. Inclusion criteria for eligibility were papers covering a population of adults with solid tumour cancers, the inclusion of at least one adverse event and the resource use and/or costs of adverse event treatment. Results From 4,985 citations, 26 eligible articles were identified. Studies were generally of moderate quality and addressed a range of cancers and treatment types. While the four issues specific to antineoplastic drug adverse events were addressed by some studies, no study addressed all of the issues in the same model. Conclusion This review indicates that current modelling assumptions may restrict our understanding of the true impact of adverse events on cost effectiveness of antineoplastic drugs. This understanding could be improved through consideration of the selection of adverse events, dose modifications, multiple events and quality of life in cost-effectiveness studies.
Norman, R, Cronin, PA & Viney, RC 2013, 'A pilot discrete choice experiment to explore preferences for EQ-5D-5L health states', Applied Health Economics and Health Policy, vol. 11, no. 3, pp. 287-298.View/Download from: UTS OPUS or Publisher's site
The EQ-5D-5L has recently been developed to improve the sensitivity of the widely used three-level version. Valuation studies are required before the use of this new instrument can be adopted. The use of discrete choice experiments (DCEs) in this area is a promising area of research. PURPOSE: To test the plausibility and acceptability of estimating an Australian algorithm for the newly developed five-level version of the EQ-5D using a DCE. METHODS: A choice experiment was designed, consisting of 200 choice sets blocked such that each respondent answered 10 choice sets. Each choice set presented two health state-duration combinations, and an immediate death option. The experiment was implemented in an online Australian-representative sample. A random-effects probit model was estimated. To explore the feasibility of the approach, an indicative algorithm was developed. The algorithm is transformed to a 0 to 1 scale suitable for use to estimate quality-adjusted life-year weights for use in economic evaluation. RESULTS: A total of 973 respondents undertook the choice experiment. Respondents were slightly younger and better educated than the general Australian population. Of the 973 respondents, 932 (95.8 %) completed all ten choice sets, and a further 12 completed some of the choice sets. In choice sets in which one health state-duration combination dominated another, the dominant option was selected on 89.5 % of occasions. The mean and median completion times were 17.9 and 9.4 min, respectively, exhibiting a highly skewed distribution. The estimation results are broadly consistent with the monotonic nature of the EQ-5D-5L. Utility is increasing in life expectancy (i.e., respondents tend to prefer health profiles with longer life expectancy), and mainly decreases in higher levels in each dimension of the instrument. A high proportion of respondents found the task clear and relatively easy to complete.
Outcome measurement in the economic evaluation of health care considers outcomes independent of to whom they accrue. This article reports on a discrete choice experiment designed to elicit population preferences regarding the allocation of health gain between hypothetical groups of potential patients. A random-effects probit model is estimated, and a technique for converting these results into equity weights for use in economic evaluation is adopted. On average, the modelling predicts a relatively high social value on health gains accruing to nonsmokers, carers, those with a low income and those with an expected age of death less than 45?years. Respondents tend to favour individuals with similar characteristics to themselves. These results challenge the conventional practice of assuming constant equity weighting. For decision makers, whether a formal equity weighting system represents an improvement on more informal approaches to weighing up equity and efficiency concerns remains uncertain
Knox, SA, Viney, RC, Gu, Y, Hole, A, Fiebig, DG, Street, D, Haas, MR, Weisberg, E & Bateson, D 2013, 'The effect of adverse information and positive promotion on women's preferences for prescribed contraceptive products', Social Science & Medicine, vol. 83, pp. 70-80.View/Download from: UTS OPUS or Publisher's site
Recent rapid growth in the range of contraceptive products has given women more choice, but also adds complexity to the resultant decision of which product to choose. This paper uses a discrete choice experiment (DCE) to investigate the effect of adverse information and positive promotion on women's stated preferences for prescribed contraceptive products. In November 2007, 527 Australian women aged 18-49 years were recruited from an online panel. Each was randomly allocated to one of three information conditions. The control group only received basic information on contraceptive products. One treatment group also received adverse information on the risks of the combined oral pill. The other group received basic information and promotional material on the vaginal ring, newly introduced into Australia and on the transdermal patch, which is unavailable in Australia. Respondents completed 32 choice sets with 3 product options where each option was described by a product label: either combined pill, minipill, injection, implant, hormonal IUD, hormonal vaginal ring, hormonal transdermal patch or copper IUD; and by the attributes: effect on acne, effect on weight, frequency of administration, contraceptive effectiveness, doctor's recommendation, effect on periods and cost. Women's choices were analysed using a generalized multinomial logit model (G-MNL) and model estimates were used to predict product shares for each information condition. The predictions indicated that adverse information did not affect women's preferences for products relative to only receiving basic information. The promotional material increased women's preferences for the transdermal patch. Women in all groups had a low preference for the vaginal ring which was not improved by promotion. The findings highlight the need for researchers to pay attention to setting the context when conducting DCEs as this can significantly affect results.
Weisberg, E, Bateson, D, Knox, SA, Haas, MR, Viney, RC, Fiebig, DG & Street, D 2013, 'Do women and providers value the same features of contraceptive products? Results of a best-worst stated preference experiment', The European Journal of Contraception & Reproductive Health Care, vol. 18, no. 3, pp. 181-190.View/Download from: UTS OPUS or Publisher's site
Objectives To determine how women and physicians rate individual characteristics of contraceptives. Methods Discrete choice experiments are used in health economics to elicit preferences for healthcare products. A choice experiment uses hypothetical scenarios to determine which individual factors infl uence choice. Women and general practitioners (GPs) were shown individual characteristics of contraceptives, not always matching existing methods, and chose the best and worst features. Results Two hundred women, mean age 36, 71% using contraception, were presented with descriptions of 16 possible methods and asked to indicate their preference for individual characteristics. One hundred and sixty-two GPs, mostly women, also completed 16 descriptions. Longer duration of action was most favoured by both, followed by lighter periods with less pain or amenorrhoea. The least attractive features for women were heavier and more painful periods, high cost, irregular periods, low effi cacy (10% failure) and weight gain of 3 kg. GPs ranked a 10% pregnancy rate as least attractive followed by heavy painful periods and a 5% failure rate. Conclusion Women and GPs differed in their ranking of contraceptive characteristics. Long duration of use, high effi cacy, minimal or no bleeding without pain, were preferred by both. Very undesirable were heavy periods especially with pain, and low effi cacy.
Haas, MR, Hall, JP, Viney, RC & Gallego, G 2012, 'Breaking up is hard to do: why disinvestment in medical technology is harder than investment', Australian Health Review, vol. 36, no. 2, pp. 148-152.View/Download from: UTS OPUS or Publisher's site
disinvestment, health technology assessment
Blinman, P, King, MT, Norman, R, Viney, RC & Stockler, MR 2012, 'Preferences for cancer treatments: an overview of methods and applications in oncology', Annals Of Oncology, vol. 23, no. 5, pp. 1104-1110.View/Download from: UTS OPUS or Publisher's site
This review provides cancer clinicians and researchers with an overview of methods for assessing preferences, with examples and recommendations for their application in oncology. Decisions about cancer treatments involve trade-offs between their relative benefits and harms. An individuals preference for a cancer treatment reflects their evaluation of the relative benefits and harms in comparison with a given alternative or alternatives. Methods of preference assessment include the ranking or rating scale, standard gamble (SG), time trade-off (TTO), visual analogue scale, discrete choice experiment (DCE), and multi-attribute utility instrument (MAUI). The choice of method depends on the purpose of preference assessment; the ranking or rating scale, SG, TTO, and DCEs are best suited to clinical decisions, whereas MAUIs are best suited to health policy decisions. Knowledge of patients preferences for cancer treatments can better inform clinical decisions about patient management by enabling the tailoring of decisions to individual patients values, attitudes, and priorities and health policy decisions through economic evaluations of cancer treatments and their suitability for coverage by health payers.
Knox, SA, Viney, RC, Street, DJ, Haas, MR, Fiebig, DG, Weisberg, E & Bateson, D 2012, 'What's good and bad about contraceptive products?: A best-worst attribute experiment comparing the values of women consumers and GPs', PharmacoEconomics, vol. 30, no. 12, pp. 1187-1202.View/Download from: UTS OPUS or Publisher's site
Background: In the past decade, the range of contraceptives available has increased dramatically. There are limited data on the factors that determine women's choices on contraceptive alternatives or what factors providers consider most important when recommending contraceptive products to women. Objectives: Our objectives were to compare women's (consumers') preferences and GPs' (providers') views in relation to existing and new contraceptive methods, and particularly to examine what factors increase the acceptability of different contraceptive products. Methods: A best-worst attribute stated-choice experiment was completed online. Participants (Australian women of reproductive age and Australian GPs) completed questions on 16 contraceptive profiles. 200 women of reproductive age were recruited through a commercial panel. GPs from all states of Australia were randomly sampled and approached by phone; 162 GPs agreed to participate. Participants chose the best and worst attribute levels of hypothetical but realistic prescribed contraceptive products. Best and worst choices were modelled using multinomial logit and product features were ranked from best to worst according to the size of model coefficients. Results: The most attractive feature of the contraceptive products for both GPs and women consumers were an administration frequency of longer than 1 year and light or no bleeding. Women indicated that the hormonal vaginal ring was the least attractive mode of administration. Conclusions: Women and GPs agree that longer-acting methods with less bleeding are important features in preferred methods of contraception; however, women are also attracted to products involving less invasive modes of administration. While the vaginal ring may fill the niche in Australia for a relatively non-invasive, moderately long-acting and effective contraceptive, the results of this study indicate that GPs will need to promote the benefits of the vaginal ring to overcome negative per...
King, M, Viney, RC, Smith, DP, Hossain, I, Street, D, Savage, EJ, Fowler, S, Berry, MP, Stockler, MR, Cozzi, P, Stricker, PD, Ward, J & Armstrong, B 2012, 'Survival gains needed to offset persistent adverse treatment effects in localised prostate cancer', British Journal Of Cancer, vol. 106, no. 4, pp. 638-645.View/Download from: UTS OPUS or Publisher's site
Men diagnosed with localised prostate cancer (LPC) face difficult choices between treatment options that can cause persistent problems with sexual, urinary and bowel function. Controlled trial evidence about the survival benefits of the full range of treatment alternatives is limited, and patients' views on the survival gains that might justify these problems have not been quantified. A discrete choice experiment (DCE) was administered in a random subsample (n = 357, stratified by treatment) of a population-based sample (n = 1381) of men, recurrence-free 3 years after diagnosis of LPC, and 65 age-matched controls (without prostate cancer). Survival gains needed to justify persistent problems were estimated by substituting side effect and survival parameters from the DCE into an equation for compensating variation (adapted from welfare economics). Median (2.5, 97.5 centiles) survival benefits needed to justify severe erectile dysfunction and severe loss of libido were 4.0 (3.4, 4.6) and 5.0 (4.9, 5.2) months. These problems were common, particularly after androgen deprivation therapy (ADT): 40 and 41% overall (n = 1381) and 88 and 78% in the ADT group (n = 33). Urinary leakage (most prevalent after radical prostatectomy (n - 839, mild 41%, severe 18%)) needed 4.2 (4.1, 4.3) and 27.7 (26.9, 28.5) months survival benefit, respectively. Mild bowel problems (most prevalent (30%) after external beam radiotherapy (n = 106)) needed 6.2 (6.1, 6.4) months survival benefit.
Fiebig, DG, Knox, SA, Viney, RC, Haas, MR & Street, D 2011, 'Preferences for new and existing contraceptive products', Health Economics, vol. 20, no. S1, pp. 35-52.View/Download from: UTS OPUS or Publisher's site
New contraceptive methods provide greater choice in terms of effectiveness, management of side-effects, convenience and frequency of administration and flexibility, but make the decisions about contraception more complex. There are limited data on the factors that determine womenâs choices among these alternatives, to inform providers about the factors which are most important to women, or to predict uptake of new products. This paper reports on a choice experiment designed to elicit womenâs preferences in relation to prescribed contraception and to forecast the impact of the introduction of two new products into the Australian market. A generalised multinomial logit model is estimated and used in the simulation exercise. The model forecasts that the hormonal patch would be well received among women, achieving a greater market share than current non-pill products, but the vaginal ring would have limited appeal.
Viney, RC, Norman, R, King, MT, Cronin, PA, Street, D, Knox, SA & Ratcliffe, J 2011, 'Time trade-off derived EQ-5D weights for Australia', Value in Health, vol. 14, no. 6, pp. 928-936.View/Download from: UTS OPUS or Publisher's site
Background: Cost-utility analyses (CUAs) are increasingly common in Australia. The EuroQol five-dimensional (EQ-5D) questionnaire is one of the most widely used generic preference-based instruments for measuring health-related quality of life for the estimation of quality-adjusted life years within a CUA. There is evidence that valuations of health states vary across countries, but Australian weights have not previously been developed. Methods: Conventionally, weights are derived by applying the time trade-off elicitation method to a subset of the EQ-5D health states. Using a larger set of directly valued health states than in previous studies, time trade-off valuations were collected from a representative sample of the Australian general population (n = 417). A range of models were estimated and compared as a basis for generating an Australian algorithm. Results: The Australia-specific EQ-5D values generated were similar to those previously produced for a range of other countries, but the number of directly valued states allowed inclusion of more interaction effects, which increased the divergence between Australia's algorithm and other algorithms in the literature. Conclusion: This new algorithm will enable the Australian community values to be reflected in future economic evaluations.
Owen, KM, Pettman, TL, Haas, MR, Viney, RC & Misan, GM 2010, 'Individual preferences for diet and exercise programmes: changes over a lifestyle intervention and their link with outcomes', Public Health Nutrition, vol. 13, no. 2, pp. 245-252.View/Download from: UTS OPUS or Publisher's site
Objective To investigate the influence of a trial lifestyle intervention on participantsï½ preferences for a range of exercise and diet programmes and whether these differ between successful and unsuccessful participants. Design Hypothetical scenarios that describe attributes of diet and exercise programmes were developed using an experimental design. Participants completed an online questionnaire at baseline, 16 weeks and 12 months where they chose their most preferred of three programmes in each of sixteen scenarios. Discrete choice modelling was used to identify which attributes participants emphasised at each time point. Subjects Fifty-five individuals who exhibited symptoms of metabolic syndrome and who participated in a 16-week trial lifestyle intervention. Results There was a clear shift in programme preferences from structure to flexibility over the intervention. At baseline, emphasis was on individually designed and supervised exercise, structured diets and high levels of support, with Gainers focusing almost exclusively on support and supervision. Losers tended to consider a wider range of programme attributes. After 16 weeks preferences shifted towards self-directed rather than organised/supervised exercise and support was less important (this depended on the type of participant and whether they were in the follow-up group). Cost became significant for Gainers following the end of the primary intervention. Conclusions The stated preference method could be a useful tool in identifying potential for success and specific needs. Gainersï½ relinquishment of responsibility for lifestyle change to programme staff may be a factor in their failure and in their greater cost sensitivity, since they focus on external rather than internal resources.
Mitchell, A & Viney, RC 2010, 'Meeting the information needs of a national drug payer: Aspirations of the guidelines from Australia', Drug Development Research, vol. 71, no. 8, pp. 463-469.View/Download from: UTS OPUS or Publisher's site
The information needs of drug payers at the provincial or national level are reasonably similar across the world. Until recently, the evidence generated to meet these needs has been largely intended to meet the information needs of regulatory agencies responsible for determining whether marketing approval should be authorized. This has meant that evidence for one purpose (determining whether a drug should be approved for marketing) usually has to be translated to meet another purpose (determining whether the drug should be paid for in a reimbursement or subsidy). As the context in each jurisdiction might be different, there is also a need to translate evidence developed for a global audience to address different local contexts. A common set of methods to translate evidence can help address both needs, from a common starting point of randomized trials as the most scientifically rigorous evidence available for estimating the extent of intended treatment effects. Experience with these methods to increase confidence in the translated evidence has proved helpful, as meeting the information needs of drug payers has recently become more influential in determining what evidence is generated during the pre-marketing research and development phase in the life cycle of a new drug
Norman, R, King, MT, Clarke, D, Viney, RC, Cronin, PA & Street, D 2010, 'Does mode of administration matter? Comparison of online and face-to-face administration of a time trade-off task', Quality of Life Research, vol. 19, no. 4, pp. 499-508.View/Download from: UTS OPUS or Publisher's site
Purpose Developments in electronic data collection methods have allowed researchers to generate larger datasets at lower costs, but relatively little is known about the comparative performance of the new methods. This paper considers the comparability of two modes of administration (face-to-face and remote electronic) for the time trade-off. Method Data were collected from a convenience sample of adults (n = 135) randomised to either a face-to-face time trade-off or a remote electronic tool. Patterns of responses were considered. For each sample, standard regression analysis was undertaken to generate a valuation set, which were then contrasted
King, MT, Viney, R, Hossain, I, Smith, D, Savage, E, Stockler, MR & Armstrong, B 2009, 'Survival gains needed to justify the side effects of treatment for localized prostate cancer.', J Clin Oncol, vol. 27, no. 15_suppl, p. 5119.
5119 Background: Men diagnosed with localized prostate cancer face difficult treatment decisions. Evidence about the relative survival benefit of treatment options is lacking or piecemeal. Side-effects can vary widely with treatment, affecting some fundamental aspects of quality of life (QOL). Little is known about patients' views of the relative tolerability of these side-effects or the survival gains needed to justify them. METHODS: QOL data were collected prospectively 3 years post-diagnosis in a population-based cohort of men treated for localized prostate cancer (n=1642); these data were used to identify common side-effect profiles. A patient preference survey was conducted in a subset (n=357, stratified by treatment); hypothetical treatment alternatives were described in terms of side-effects and survival. Random parameter logit models were estimated. We adapted the concept of compensating variation from welfare economics to derive a parameter function for the value of changes in QOL in terms of survival time; i.e., the survival gains needed to justify persistent side-effects. Bootstrap confidence intervals (CI) were constructed. RESULTS: The table shows the survival gains needed for a range of common treatment profiles, relative to the base case of active surveillance (in which men typically experienced mild loss of libido and mild fatigue). For example, radical prostatectomy often resulted in severe impotence and mild urinary leakage; men required an extra 8.0 months (95% CI 7.4-8.7) of life to make this worthwhile. Generally, urinary dysfunction and bowel symptoms were considered the least tolerable, hormonal symptoms and fatigue came next, and sexual dysfunction was considered relatively benign. This pattern was relatively consistent across treatment groups. CONCLUSIONS: These results highlight the need for better evidence about the actual survival benefits of alternative treatments. They also help to target supportive care to optimize patient QOL after...
Mitchell, A, Isaacs, D, Buttery, J & Viney, RC 2009, 'Funding of drugs: do vaccines warrant a different approach?', Lancet Infectious Diseases, vol. 9, no. 5, pp. 269-270.View/Download from: Publisher's site
Fiebig, DG, Haas, MR, Hossain, I, Street, D & Viney, RC 2009, 'Decisions about Pap tests: What influences women and providers?', Social Science & Medicine, vol. 68, no. 10, pp. 1766-1774.View/Download from: UTS OPUS or Publisher's site
Despite the success internationally of cervical screening programs debate continues about optimal program design. This includes increasing participation rates among under-screened women, reducing unnecessary early re-screening, improving accuracy of and confidence in screening tests, and determining the cost-effectiveness of program parameters, such as type of screening test, screening interval and target group. For all these issues, information about consumer and provider preferences and insight into the potential impact of any change to program design on consumer and provider behaviour are essential inputs into evidence-based health policy decision making. This paper reports the results of discrete choice experiments to investigate women's choices and providers' recommendations in relation to cervical screening in Australia. Separate experiments were conducted with women and general practitioners, with attributes selected to allow for investigation of how women and general practitioners differ in their preferences for attributes of screening programs. Our results indicate a considerable commonality in preferences but the alignment was not complete. Women put relatively more weight on cost, chance of a false positive and if the recommended screening interval were changed to one year.
Norman, R, Cronin, PA, Viney, RC, King, MT, Street, D & Ratcliffe, J 2009, 'International comparisons in valuing EQ-5D health states: A review and analysis', Value in Health, vol. 12, no. 8, pp. 1194-1200.View/Download from: UTS OPUS or Publisher's site
Objective: To identify the key methodological issues in the construction of population-level EuroQol 5-dimensions (EQ-5D)/time trade-off (TTO) preference elicitation studies. Method: This study involved three components. The first was to identify existing population-level EQ-5D TTO studies. The second was to illustrate and discuss the key areas of divergence between studies, including the international comparison of tariffs. The third was to portray the relative merits of each of the approaches and to compare the results of studies across countries. Results: While most articles report use of the protocol developed in the original UK study, we identified three key areas of divergence in the construction and analysis of surveys. These are the number of health states valued to determine the algorithm for estimating all health states, the approach to valuing states worse than immediate death, and the choice of algorithm. The evidence on international comparisons suggests differences between countries although it is difficult to disentangle differences in cultural attitudes with random error and differences as a result of methodological divergence. Conclusions: Differences in methods may obscure true differences in values between countries. Nevertheless, population-specific valuation sets for countries engaging in economic evaluation would better reflect cultural differences and are therefore more likely to accurately represent societal attitudes.
Van Gool, K, Savage, EJ, Viney, RC, Haas, MR & Anderson, R 2009, 'Who's getting caught? An analysis of the Australian Medicare Safety Net', The Australian Economic Review, vol. 42, no. 2, pp. 143-154.View/Download from: UTS OPUS or Publisher's site
The Medicare Safety Net (MSN) was introduced in March 2004 to provide financial relief for those who incur high out-of-pocket costs from medical services. The policy has the potential to improve equity. This study examines: (i) how the health and income profiles of small areas influence MSN expenditure; and (ii) the distribution of expenditure by medical service type. The results indicate that MSN expenditure is positively related to income and that patients who use private obstetricians and assisted reproductive services are the greatest beneficiaries. The MSN has possibly created greater inequities in Australia's health-care financing arrangements.
Kenny, PM, King, MT, Viney, RC, Boyer, M, Pollicino, C, McLean, J, Fulham, MJ & McCaughan, BC 2008, 'Quality of life and survival in the 2 years after surgery for non-small-cell lung cancer', Journal of Clinical Oncology, vol. 26, no. 2, pp. 233-241.View/Download from: UTS OPUS or Publisher's site
Purpose Although surgery for early-stage non-small-cell lung cancer ( NSCLC) is known to have a substantial impact on health-related quality of life (HRQOL), there are few published studies about HRQOL in the longer term. This article examines HRQOL and survival in the 2 years after surgery. Patients and Methods Patients with clinical stage I or II NSCLC (n = 173) completed HRQOL questionnaires before surgery, at discharge, 1 month after surgery, and then every 4 months for 2 years. HRQOL was measured with a generic cancer questionnaire (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire [ EORTC-QLQ] C30) and a lung cancer-specific questionnaire (EORTC QLQ-LC13). Data were analyzed to examine the impact of surgery and any subsequent therapy, and to describe the trajectories of those who remained disease free at 2 years and those with recurrent cancer diagnosed during follow-up. Results Disease recurred within 2 years for 36% of patients and 2-year survival was 65%. Surgery substantially reduced HRQOL across all dimensions except emotional functioning. HRQOL improved in the 2 years after surgery for patients without disease recurrence, although approximately half continued to experience symptoms and functional limitations. For those with recurrence within 2 years, there was some early postoperative recovery in HRQOL, with subsequent deterioration across most dimensions.
Scuffham, P, Whitty, J, Mitchell, A & Viney, RC 2008, 'The use of QALY weights for health state valuation and QALY calculations: A review of industry submissions requesting listing on the Australian Pharmaceutical Benefits Scheme 2002 to 2004', Pharmacoeconomics, vol. 26, no. 4, pp. 297-310.View/Download from: UTS OPUS or Publisher's site
Hall, JP & Viney, RC 2008, 'National health reform needs strategic investment in health services research', Medical Journal of Australia, vol. 188, no. 1, pp. 33-35.View/Download from: UTS OPUS or Publisher's site
With new funding for the National Health and Medical Research Council (NHMRC) to provide an evidence base for policy and practice reform, it is timely to revisit Australia's recent experiences with health services research and policy development. We provide a broad review of the contribution of Australian health services research to the development of health policy over the past 20 years. We conclude that three preconditions are necessary to influence policy: political will; sustained funding to encourage methodological rigour and build decision makers' confidence; and the development of sufficient capacity and skills.
Van Gool, K, Gallego, G, Haas, MR, Viney, RC, Hall, JP & Ward, R 2007, 'Economic evidence at the local level: Options for making it more useful', Pharmacoeconomics, vol. 25, no. 12, pp. 1055-1062.View/Download from: UTS OPUS or Publisher's site
Like other countries, Australia has had some success in incorporating economic evidence into national healthcare decisions. However, it has been recognised that this coverage does not extend to the local hospital or health region level. An extensive body of research has identified barriers to the use of economic evidence at the local level, leading some commentators to suggest that economic evaluation should only be targeted at national decision-making bodies. Yet, local decision makers in Australia and elsewhere make important choices about the uptake and diffusion of healthcare technologies. We propose a number of interrelated options to address the barriers that currently prohibit the use of economic evaluation by local decision makers in many jurisdictions. These include wider dissemination of user friendly models, inclusion of assessments of the cost impact of interventions on various budgets, and the establishment of an authoritative body that ensures the production of high quality economic models. It is argued that these options can have a significant impact on the way economic evaluations are conducted, reported, disseminated and used.
Owen, K, Haas, MR & Viney, R 2007, 'Expectations of outcomes and individuals' framing of the benefits and effort required in diet and exercise', International Journal of Obesity, vol. 31, no. Suppl 1, pp. S147-S147.
Belkar, R, Fiebig, DG, Haas, MR & Viney, RC 2006, 'Why worry about awareness in choice problems? Econometric analysis of screening for cervical cancer', Health Economics, vol. 15, no. 1, pp. 33-47.View/Download from: UTS OPUS or Publisher's site
The decision to undertake a screening test is conditional upon awareness of screening. From an econometric perspective there is a potential selection problem, if no distinction is made between aware and unaware non-screeners. This paper explores this pro
Warren, E, Viney, RC, Shearer, J, Shanahan, M, Wodak, AD & Dolan, K 2006, 'Value for money in drug treatment economic evaluation of prison methadone', Drug and Alcohol Dependence, vol. 84, no. 2, pp. 160-166.View/Download from: UTS OPUS or Publisher's site
Background: Although methadone maintenance treatment in community settings is known to reduce heroin use, HIV infection and mortality among injecting drug users (IDU), little is known about prison methadone programs. One reason for this is the complexity
Fulham, MJ, McCaughan, BC, Boyer, MJ, McLean, JM, Kenny, PM, King, MT, Pollicino, CA & Viney, RC 2005, 'FDG-PET in addition to conventional work-up in non-small-cell lung cancer - In reply', JOURNAL OF CLINICAL ONCOLOGY, vol. 23, no. 7, pp. 1591-1592.View/Download from: Publisher's site
Fulham, M.J., McCaughan, B.C., Boyer, M., McLean, J., Kenny, P.M., King, M.T., Pollicino, C. & Viney, R.C. 2005, 'FDG-PET in Stage I/II NSCLC: the Australian RCT', Journal of Clinical Oncology, vol. 23, pp. 591-592.
Viney, RC, Savage, EJ & Louviere, JJ 2005, 'Empirical investigation of experimental design properties of discrete choice experiments in health care', Health Economics, vol. 14, no. 4, pp. 349-362.View/Download from: UTS OPUS or Publisher's site
Experimental design is critical to valid inference from the results of discrete choice experiments (DCEs). In health economics, DCEs have placed limited emphasis on experimental design, typically employing relatively small fractional factorial designs, w
Mulhern, RK, Khan, RB, Kaplan, S, Helton, S, Christensen, R, Bonner, M, Brown, R, Xiong, XP, Wu, SJ, Gururangan, S & Reddick, WE 2004, 'Short-term efficacy of methylphenidate: A randomized, double-blind, placebo-controlled trial among survivors of childhood cancer', JOURNAL OF CLINICAL ONCOLOGY, vol. 22, no. 23, pp. 4795-4803.View/Download from: Publisher's site
Viney, RC, Boyer, M, King, MT, Kenny, PM, Pollicino, C, McLean, J, McCaughn, B & Fulham, MJ 2004, 'Randomized controlled trial of the role of positron emission tomography in the management of stage I and II non-small-cell lung cancer', Journal of Clinical Oncology, vol. 22, no. 12, pp. 2357-2362.View/Download from: UTS OPUS or Publisher's site
Viney, RC, Boyer, M & King, MT 2004, 'Staging lung cancer using positron emission tomography and the impact on care', Journal of Clinical Outcomes Management, vol. 11, no. 8, pp. 486-488.View/Download from: UTS OPUS
Harris, L & Viney, RC 2003, 'Health science curriculum reform: a framework for evaluation', Assessment and Evaluation in Higher Education, vol. 28, no. 4, pp. 411-422.View/Download from: UTS OPUS or Publisher's site
Kenny, PM, Hall, JP, Viney, RC & Haas, MR 2003, 'Do participants understand a stated preference health survey? a qualitative approach to assessing validity', International Journal of Technology Assessment in Health Care, vol. 19, no. 4, pp. 664-681.View/Download from: UTS OPUS
Hall, JP, Kenny, PM, King, MT, Louviere, JJ, Viney, RC & Yeoh, A 2002, 'Using stated preference discrete choice modelling to evaluate the introduction of varicella vaccination', Health Economics, vol. 11, no. 5, pp. 457-465.View/Download from: UTS OPUS or Publisher's site
Applications of stated preference discrete choice modelling (SPDCM) in health economics have been used to estimate consumer willingness to pay and to broaden the range of consequences considered in economic evaluation. This paper demonstrates how SPDCM can be used to predict participation rates, using the case of varicella (chickenpox) vaccination. Varicella vaccination may be cost effective compared to other public health programs, but this conclusion is sensitive to the proportion of the target population immunised. A choice experiment was conducted on a sample of Australian parents to predict uptake across a range of hypothetical programs. Immunisation rates would be increased by providing immunisation at no cost, by requiring it for school entry, by increasing immunisation rates in the community and decreasing the incidence of mild and severe side effects. There were two significant interactions; price modified the effect of both support from authorities and severe side effects. Country of birth was the only significant demographic characteristic. Depending on aspects of the immunisation program, the immunisation rates of children with Australian-born parents varied from 9% to 99% while for the children with parents born outside Australia they varied from 40% to 99%. This demonstrates how SPDCM can be used to understand the levels of attributes that will induce a change in the decision to immunise, the modification of the effect of one attribute by another, and subgroups in the population. Such insights can contribute to the optimal design and targeting of health programs.
Van Gool, K, Haas, MR & Viney, RC 2002, 'From flying doctor to virtual doctor: an economic perspective on Australia's telemedicine experience', Journal of Telemedicine and Telecare, vol. 8, pp. 249-254.View/Download from: UTS OPUS or Publisher's site
Viney, RC, Lancsar, E & Louviere, JJ 2002, 'Discrete choice experiments to measure consumer preferences for health and healthcare', Pharmaeconomics Outcomes Research: Expert Review, vol. 2, no. 4, pp. 319-326.View/Download from: UTS OPUS or Publisher's site
Van Gool, K, Lancsar, E, Viney, RC, Hall, JP & Haywood, P 2002, 'Diagnosis and prognosis of Australia's health information for evidence based policy', Journal of Health Services Research & Policy, vol. 7, no. 1, pp. 40-45.View/Download from: UTS OPUS or Publisher's site
Pollicino, C, Viney, RC & Haas, MR 2002, 'Measuring health system resource use for economic evaluation: a comparison of data source', Australian Health Review, vol. 25, no. 3, pp. 171-178.View/Download from: UTS OPUS
Haas, MR, Chapman, S, Viney, RC, Hall, JP & Ferguson, A 2001, 'The news on health care costs: a study of reporting in the Australian print media for 1996', Journal of Health Services Research and Policy, vol. 6, pp. 78-84.
Haas, MR, Viney, RC, Kristensen, E, Pain, C & Foulds, K 2001, 'Using programme budgeting and marginal analysis to assist population-based strategic planning for coronary heart disease', Health Policy, vol. 55, pp. 173-186.View/Download from: Publisher's site
Viney, RC 2001, 'Funding arrangements for pharmaceuticals: can economic evaluation promote efficiency?', Australian Health Review, vol. 24, pp. 21-24.
Hall, JP, Lourenco, R & Viney, RC 1999, 'Carrots And Sticks - The Fall And Fall Of Private Health Insurance In Australia', Health Economics, vol. 8, no. 8, pp. 653-660.View/Download from: UTS OPUS or 3.0.CO;2-I">Publisher's site
Hall, JP, Viney, RC & Haas, MR 1998, 'Taking A Count The Evaluation Of Genetic Testing', Australian And New Zealand Journal Of Public Health, vol. 22, no. 7, pp. 754-758.View/Download from: Publisher's site
While some forms of genetic testing have been available for decades, the progress of the Human Genome Project will expand the possibilities for testing. Evaluation of genetic testing is warranted because health care services have an opportunity cost and
Cromwell, D, Viney, RC, Halsall, J & Hindle, D 1998, 'Linking Measures Of Health Gain To Explicit Priority Setting By An Area Health Service In Australia', Social Science & Medicine, vol. 47, no. 12, pp. 2067-2074.View/Download from: Publisher's site
A demonstration project was undertaken to develop, an integer programming model that could help a regional health authority to take into account data on service effectiveness when allocating resources to acute inpatient services. The model was designed t
Viney, R & Haas, M 1998, 'Funding arrangements for telehealth: encouraging efficiency rather than proliferation.', Australian health review : a publication of the Australian Hospital Association, vol. 21, no. 3, pp. 34-48.
The use of telehealth as a basis for delivering health services is growing across Australia, and there is clear potential for these technologies to address some of the enduring issues of access and costs of service delivery. However, appropriate incentives must be created to encourage clinicians and managers to evaluate the true opportunity costs and benefits of delivering services in this way against the relevant alternative. This paper examines how different funding arrangements might encourage or discourage efficient use of telehealth.
Viney, R, Haas, MR & Seymour, J 1996, 'Seeing through the smoke: Using economic evaluation to allocate health promotion resources to prevent smoking', Health Promotion Journal of Australia, vol. 6, no. 1, pp. 7-15.
Keith, AR, Pirkis, JE, Viney, RC, Katz, CM, Lagaida, RM, Britt, H & Baden, L 1993, 'Delivery of primary care in hospital and community settings in Australia', International Journal for Quality in Health Care, vol. 5, no. 2, pp. 131-141.View/Download from: Publisher's site
This study examined the interface between emergency departments and community general practice in terms of their delivery of primary care services. Through the collection of casemix and treatment data, and interviews with patients, information was gathered relating to the extent of primary care delivery in emergency departments, problems managed and treatments provided in the two settings and patients' characteristics and reasons for choosing to seek primary care in the emergency department. The results indicate a high proportion of primary care delivery is in emergency departments, and that there is a need for delivery in this setting to continue. The results are discussed in terms of such quality assurance issues as monitoring primary care in emergency departments and addressing patient needs. © 1993 Pergamon Press Ltd.
Viney, R, Keith, A, Williams, P & Laffey, J 1991, 'Case payment: A New South Wales perspective', Australian Health Review, vol. 14, no. 3, pp. 235-244.
This paper addresses the role of casemix systems within the NSW public health system. In NSW, Areas and Regions are funded according to a casemix modified population-based funding formula (Resource Allocation Formula). The RAF is compared with case payment as a means of funding hospitals. It is argued that because of the current shortcomings in casemix funding, including output orientation, inapplicability to ambulatory and non-acute inpatients, and limited scope for global expenditure control, case payment should not be introduced as the mechanism for funding hospitals. However, it is recognised that there is scope to combine population-based funding at area/region level, with case payment to individual agencies.
Dwyer, T, Viney, R & Jones, M 1991, 'Assessing school health education programs', International Journal of Technology Assessment in Health Care, vol. 7, no. 3, pp. 286-295.View/Download from: Publisher's site
This review focuses on the component of health education directed at achieving changes in health behavior. Much of the work in this field has centered on health behavior that has a role in preventing future disease. Because the evidence is strongest in relation to coronary heart disease (17), considerable effort has been devoted to this area. Walter et al. (34) indicated that the most relevant forms of health behavior to be considered in school-based programs on heart disease are those relating to diet, physical activity, and smoking. Programs relating to each of these behaviors are addressed here. © 1991, Cambridge University Press. All rights reserved.
Viney, RC 1989, 'Community Intervention For Hypertension - Economic-evaluation', Community Health Studies, vol. 13, no. 3, pp. 365-365.
Viney, RC, Hall, J, Duckett, S & Moran, S 2018, 'Health economics' in The future of precision medicine in Australia, Australian Council of Learned Academies (ACOLA), Melbourne, pp. 100-113.View/Download from: UTS OPUS
Haas, MR & Viney, RC 2012, 'Health insurance' in Sheridan, H (ed), The law handbook: your practical guide to the law in NSW 12th edition, Thomson Reuters (Professional) Australia Ltd, Prymont, NSW, pp. 908-914.
Louviere, JJ, Viney, RC, Street, D & Burgess, LB 2012, 'Design of Choice Experiments in Health Economics' in Jones, AM (ed), The Elgar Companion to HEalth Econimics, Second Edition, Edward Elgar Publishing Limited, Northampton, MA, USA, pp. 447-462.View/Download from: UTS OPUS
In many areas of applied economics, economists use observations of actual choices, or revealed preference (RP) data, to model behaviour. Individuals are assumed to make utility maximizing choices, and utility functions are estimated by analysing observed choices. A need for stated preference (SP) data arises when there are limited or no RP data available, because the good or service is new, not provided in a market context, or there is insufficient variability in choice attributes to obtain reliable estimates of their effects. Discrete choice experiments (DCEs) are an SP method of interest in health economics because they allow analysis of preferences for complex, multi-attribute goods like health care.
Haas, MR, Tschaut, N & Viney, RC 2009, 'Health insurance' in Fallon, M (ed), The law handbook: Your practical guide to the law in New South Wales 11th edition, Redfern Legal Centre, Redfern, pp. 843-849.
Street, D, Burgess, LB, Viney, RC & Louviere, JJ 2008, 'Designing Discrete Choice Experiments for Health Care' in Ryan, M, Gerard, K & Amaya-Amaya, M (eds), Using Discrete Choice Experiments to Value Health and Health Care, Springer, Dordrecht, The Netherlands, pp. 47-72.View/Download from: UTS OPUS or Publisher's site
As noted in Chapter 1, the application of discrete choice experiments (DCEs) in health economics has seen an increase over the last few years.While the number of studies using DCEs is growing, there has been relatively limited consideration of experimental design theory and methods. Details of the development of the designed experiment are rarely discussed. Many studies have used small fractional factorial designs (FFDs), generated with commercial design software packages, e.g. orthogonal main effects plans (OMEPs), sometimes manipulated in ad hoc ways (e.g. randomly pairing up scenarios or taking one scenario from the design and combining it with every other scenario). Such approaches can result in designs with unknown statistical design properties, in particular with unknown correlations between parameter estimates.
Burgess, LB, Street, D, Viney, RC & Louviere, JJ 2006, 'Design of choice experiments in health economics' in Jones, AM (ed), The Elgar Companion to Health Economics, Edward Elgar, Cheltenham, UK, pp. 415-426.View/Download from: UTS OPUS
Trevena, L, Mulhern, B, Viney, R & De Abreu Lourenco, R 2018, 'That's what I want to avoid: Do clinical recommendations on risk reduction mirror what the community wants to avoid?', PC4 Scientific Symposium, Sydney.
Duong, M, Hilmer, S, Le Couteur, D, Gnjidic, D, McLachlan, A, Viney, RC, Baysari, M, Bennett, S & Blyth, F 2018, 'Designing tools to support review and reduction of inappropriate polypharmacy in older inpatients', 78th FIP World Congress of Pharmacy and Pharmaceutical Sciences, Glasgow, Scotland.
Manipis, K, Mulhern, B, Pearce, A, Haywood, P, Viney, R & Goodall, S 2018, 'Estimating the willingness to pay to avoid the impacts of foodborne illnesses: A Discrete Choice Experiment', ISPOR Asia Pacific 2018, Tokyo, Japan.
Scarf, V, Viney, R, Cheah, S & Homer, C 2018, 'Estimated costs associated with birth at home, in a birth centre or in a hospital: a micro-costing', WOMEN AND BIRTH, ELSEVIER SCIENCE BV, pp. S51-S52.View/Download from: Publisher's site
Mulhern, BJ, Norman, R, Street, D, Lancsar, E, Ratcliffe, J, Shah, K, Lorgelly, P & Viney, R 2018, 'A comparison of the EQ-VT protocol and DCE with duration', EuroQol Plenary Meeting, Lisbon, Portugal.
Mulhern, B, Norman, R, De Abreu Lourenco, R & Viney, R 2017, 'Investigating the relative value of health and social care related quality of life using discrete choice', International Society for Pharmacoeconomics and Outcomes Research 22nd Annual International Meeting, Boston, USA.
Viney, RC, Mulhern, B, Norman, R & De Abreu Lourenco, R 2017, 'Investigating the relative value of health and social care related quality of life using discrete choice experiments [Conference Presentation]', iHEA Boston World Congress, Boston, USA.
Manipis, K, Mulhern, B, Haywood, P, Viney, R & Goodall, S 2017, 'Estimating the impact of paid and unpaid sick leave on preferences for avoiding the negative impacts of foodborne illnesses [conference presentation]', 39th Annual Australian Health Economics Society Conference, Sydney.
Arora, S, Goodall, S, Viney, R & Einfeld, S 2017, 'The health-related quality of life of caregivers of children with intellectual disability [Conference Presentation]', 39th Annual Australian Health Economics Society Conference, Sydney.
Viney, RC 2017, 'Evaluating pharmaceuticals: How far have we come, how much further to go?', Whitlam Policy Forum, Canberra.
Viney, RC 2017, 'Using Patient Reported Outcome Measures to improve health system performance', Department of Health Roundtable, Canberra.
Viney, RC 2017, 'Estimating latent scale discrete choice utilities to develop and EQ-5D-Y value set in the UK (Discussant)', 34th EuroQol Plenary Meeting, Barcelona.
Viney, RC 2017, 'Line of sight to value for money in the eye drugs', HTA Consumer Workshop, Melbourne.
Scarf, V, Cheah, S, Homer, CSE & Viney, R 2017, 'How can the cost of giving birth be estimated by tracing the birth trajectory of women with healthy pregnancies?', WOMEN AND BIRTH, ELSEVIER SCIENCE BV, pp. 27-27.View/Download from: Publisher's site
Norman, R, King, M, Viney, RC, Aaronson, N, Brazier, J, Cella, D, Costa, D, Fayers, P, Kemmler, G, Mercieca-Bebber, R & Peacock, S 2017, 'Australian utility weights for the EORTC QLU-CD10, a multi-attribute utility instrument derived from the cancer-specific quality of life questionnaire, EORTC QLU-C30 [Conference Presentation]', iHEA Boston World Congress, Boston, USA.
Norman, R, Viney, R, Mulhern, B, Brazier, J, Ratcliffe, J, Lancsar, E, Lorgelly, P, Street, D & Flattery, M 2017, 'A large Australian DCE with duration and dead to value EQ-5D-5L health states [Conference Presentation]', 34th EuroQol Plenary Meeting, Barcleona.
Mulhern, B, Norman, R, Viney, R, Street, D & Flattery, M 2017, 'Assessing the relationship between the EQ-5D-5L descriptive system and a range of outcome measures using psychometric and Rasch analysis [Conference Presentation]', 34th EuroQol Plenary Meeting, Barcelona.
Flattery, M, Mulhern, B, Norman, R, Viney, R, Street, D, Feng, Y, Addo, R, Manipis, K, Meshcheriakova, O & Saing, S 2017, 'Valuing EQ-5D-5L in Australia using an adapted EQ-VT: Informing the further development of a revised valuation protocol', 34th EuroQol Plenary Meeting, Barcelona.
Arora, S, Goodall, S, Einfeld, S & Viney, R 2016, 'Using Discrete Choice experiments to value informal care provided to children with intellectual disabilities', ISPOR 7th Asia-Pacific Conference, Singapore.
Saing, S, Kemmler, G, Gamper, EM, Daval, F, Holzner, B, Pivot, X, Viney, R & Nerich, V 2016, 'Cost-utility analyses of drug therapies in breast cancer: a systematic review and critical appraisal of health-state utility values', 38th Annual Australian Health Economics Society Conference, Australian Health Economics Society Conference, Perth.
Cronin, PA, Reeve, R, Goodall, S, Viney, R & McCabe, T 2016, 'The implications of school quality on the academic achievements of children with language difficulties', 38th Annual Australian Health Economics Society Conference, Australian Health Economics Society Conference, Perth.
Mulhern, BJ, De Abreu Lourenco, R & Viney, R 2016, 'Investigating the relative value of health and social care related quality of life using discrete choice', 38th Annual Australian Health Economics Society Conference, Perth.
De Abreu Lourenco, R, Haas, M, Hall, J, Parish, K, Stuart, D & Viney, R 2016, 'Placing a value on avoiding cancer recurrence: women's preferences for contralateral prophylactic mastectomy', 38th Annual Australian Health Economics Society Conference, Perth.
Arora, S, Goodall, S, Viney, R & Einfeld, S 2016, 'Using a discrete choice experiment to value informal care provided to children with intellectual disabilities', 38th Annual Australian Health Economics Society Conference, Perth.
Meshcheriakova, O, Goodall, S & Viney, R 2016, 'Consumer preferences for food processing technologies: evidence from a discrete choice experiment', 38th Annual Australian Health Economics Society Conference, Perth.
Lourenco, RDA, Haas, M, Hall, J, Parish, K, Stuart, D & Viney, R 2016, 'Women's preferences for avoiding cancer recurrence: a focus on contralateral prophylactic mastectomy', Asia-pacific Journal of Clinical Oncology, pp. 137-137.
Goodall, S, Viney, R, Zhao, F-L & Street, D 2016, 'Estimating the impact of direct-to-consumer advertising of pharmacy only medicines using discrete choice experiments', ISPOR 7th Asia-Pacific Conference, Singapore.
Parkinson, B, Viney, RC, Goodall, S & Haas, M 2015, 'Real-world observational data in cost-effectiveness analyses: Herceptin as a case study', iHEA 11th World Congress on Health Economics, Milan, Italy.
Cronin, P, Reeve, R, Goodall, S, McCabe, P & Viney, RC 2015, 'The impact of childhood language impairment on health service use and health care expenditure', IHEA, 11th World Congress on Health Economics, Milan, Italy.
Cronin, PA, Reeve, R, Goodall, S, McCabe, P & Viney, R 2015, 'The impact of childhood language impairment on health service use and health care expenditure-evidence from the Longitudinal Study of Australian Children', Childhood Language Symposium, Warwick, UK.
Viney, R, Mulhern, BJ, Norman, R, Ratcliffe, J, Lorgelly, P, Lancsar, E & Brazier, J 2015, 'What is the impact of the order of EQ-5D-5L dimensions on health state values elicited using DCE with duration?', EuroQol Group Plenary 2015, Krakow, Poland.
Viney, RC 2015, 'A checklist for reporting valuation studies of multi-attribute utility-based instruments (CREATE)', EuroQol Group Plenary 2015, Krakow, Poland.
Reeve, R, Butler, K, Burns, L, Viney, RC, Arora, S, Goodall, S & van Gool, K 2015, 'The costs and consequences of targeting AOD patients presenting to Hospital Emergency Departments', APSAD Annual Scientific Alcohol and Drug Conference, Perth.
Pearce, AM, Haas, M, Viney, R, Pearson, S, Haywood, P & Ward, R 2014, 'Rates of chemotherapy adverse event in clinical practice: results from a prospective cohort study', World Cancer Congress, Melbourne.View/Download from: UTS OPUS
Reeve, RD, Srasuebkul, P, Haas, MR, Pearson, S & Viney, RC 2014, 'Utilisation and cost of health services in the last six months of life: A comparison of cohorts with and without cancer', CAER 11th Annual Summer Workshop, Sydney.
Parkinson, B.T., Pearson, S. & Viney, R.C. 2013, 'Economic evaluations of trastuzumab in HER2 positive metastatic breast cancer: a systematic review and critique', iHEA 9th World Congress on Health Economics, Sydney.
Viney, R.C. 2013, 'Theory, data, analysis and a snag on the barbie: How health economics has contributed to health policy in Australia [plenary]', iHEA 9th World Congress on Health Economics, Sydney.
Gu, Y, Norman, R & Viney, RC 2013, 'Estimating health state utility values from discrete choice experiments: a QALY space model approach', Fourth Australasian Workshop on Econometrics and Health Economics, Launceston, Tasmania.
Gu, Y., Norman, R. & Viney, R.C. 2013, 'Estimating QALY values from discrete choice experiments using mixed logit models', 3rd International Choice Modelling Conference, Sydney.
Reeve, RD, Srasuebkul, P, Pearson, S, Haas, MR & Viney, RC 2013, 'Resource use and costs of cancer care at the end of life', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Reeve, RD, Church, J, Haas, MR, Bradford, W & Viney, RC 2013, 'What factors drive the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote New South Wales?', World Diabetes Congress 2013, Melbourne.
Norman, R, Viney, RC, Street, D, Cronin, PA & Ratcliffe, J 2013, 'Using choice experiments to explore preferences for health profiles with different survival durations: experience from Australia', iHEA 9th World Congress on Health Economics, Sydney.
Gu, Y., Norman, R. & Viney, R.C. 2012, 'Estimating QALY values from discrete choice experiments using mixed logit models', 34th Australian Conference of Health Economists (AHES), Darwin.
Parkinson, B.T., Viney, R.C. & Pearson, S. 2012, 'Trastuzumab: how economic evaluations arrive at different conclusions', 34th Australian Conference of Health Economists, Darwin.
Norman, R, Viney, RC, Brazier, JE, King, MT, Cronin, PA, Ratcliffe, J & Street, D 2012, 'Australian algorithms for the EQ-5D-3L and EQ-5D-5L', International Society for Quality of Life Research Congress, Budapest, Hungary.
Norman, R, Brazier, JE, Viney, RC, Burgess, LB, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2012, 'Revaluing the SF-6D using ordinal methods for eliciting preferences', International Society for Quality of Life Research Congress, Budapest, Hungary.
Norman, R, Viney, RC, Brazier, JE, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2012, 'Using discrete choice experiments to value health states for economic evaluation: The SF-6D in Australia', ISPOR Asia-Pacific Congress, Taiwan.
Norman, R, Viney, RC, Brazier, JE, Burgess, LB, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2012, 'A DCE-derived algorithm for the SF-6D', 34th Australian Conference of Health Economists (AHES), Darwin.
Viney, R.C. 2011, 'The methods of carrying out the drug evaluation process for the Australian Phamaceutical Benefits Scheme', Seminar of Australian Pharmaceutical Pricing Management. National Development and Reform Commission, Drug Pricing Evaluation Centre, Beijing, China.
Knox, SA, Viney, RC, Gu, Y, Hole, A, Fiebig, DG, Street, D & Haas, MR 2011, 'The effect of information and promotion on preferences for contraceptive products', iHEA 8th World Congress, Toronto, Canada.
Fiebig, DG, Viney, RC, Knox, SA, Haas, MR, Weisberg, E, Street, D & Bateson, D 2011, 'Talking about contraception: how do doctors decide what to discuss and recommend?', iHEA 8th World Congress, Toronto, Canada.
Knox, SA, Viney, RC, Street, D, Haas, MR, Fiebig, DG, Weisberg, E & Bateson, D 2010, 'Whatâs good and bad about contraception? Application of a Best-Worst Attribute experiment', CAER Health Economics Workshop, Sydney.
King, MT, Viney, R, Hossain, I, Smith, D, Savage, E, Stockler, MR & Armstrong, B 2009, 'Survival gains needed to justify the side effects of treatment for localized prostate cancer', JOURNAL OF CLINICAL ONCOLOGY, 45th Annual Meeting of the American-Society-of-Clinical-Oncology, AMER SOC CLINICAL ONCOLOGY, Orlando, FL.
Haas, MR, Viney, RC, Gallego, G & Hall, JP 2009, 'Implementing guidelines for reimbursement in Australia: How the PBAC & MSAC use comparative cost-effectiveness', International Network Health Policy and Reform Meeting, Krakow, Poland.
Owen, KM, Pettman, TL, Haas, MR, Viney, RC & Misan, GM 2009, 'Individual preferences for diet and exercise programs: changes over a lifestyle intervention and their link with outcomes', Australian Conference of Health Economists, Hobart.
Johar, M, Fiebig, DG, Haas, MR & Viney, RC 2009, 'Evaluating changes in women's attitudes towards cervical screening following a screening promotion campaign and a free vaccination', 6th Health Services and Policy Research Conference 2009, Brisbane.
Cronin, PA, Norman, R, Viney, RC, King, MT, Street, D, Burgess, LB, Brazier, JE & Ratcliffe, J 2009, 'Can Time Trade Off be implemented online? A case study from Australia using the EQ-5D (Poster)', iHEA 7th World Congress, Beijing, China.
Viney, RC, Norman, R, Street, D, King, MT, Burgess, LB, Brazier, JE & Ratcliffe, J 2009, 'Application of discrete choice experiments to value multi-attribute health states: experimental design issues', iHEA 7th World Congress, Beijing, China.
Knox, SA, Viney, RC, Street, D, Haas, MR, Weisberg, E & Bateson, D 2009, 'Do women and GPs agree in their preferences around contraceptive methods?', 6th Health Services and Policy Conference 2009, Brisbane.
Viney, R.C. 2008, 'Does cost-effectiveness enhance access?', CREATE08 (Clinical Research and Trials Excellence) Conference, Malaysia.
Viney, R.C. 2008, 'Developing and implementing pharmacoeconomic guidelines: lessons from Australia (plenary)', International Society of Pharmacoeconomics and Outcomes Research Asia-Pacific Congress, Seoul, Korea.
Viney, R.C. 2008, 'Assessing QALYs: the EQ-5D', Quality of Life Workshop, University of Sydney.
Viney, R.C. 2008, 'Health economics and the PBS: an overview', Association of Regulatory and Clinical Scientists Annual Scientific Congress, Sydney.
Knox, SA, Fiebig, DG, Viney, RC, Haas, MR, Weisberg, E, Street, D, Bateson, D & Cheung, SS 2008, 'Choosing how not to get pregnant: evidence from a discrete choice experiment', 30th Australian Conference Of Health Economists, Adelaide.
Viney, RC, Norman, R, King, MT, Cronin, PA, Street, D, Brazier, JE & Ratcliffe, J 2008, 'Application of discrete choice experiments to value multi-attribute health states for use in economic evaluation', Australian Conference of Health Economists, Adelaide.
Viney, RC, Norman, R, King, MT, Cronin, PA, Street, D, Ratcliffe, J & Brazier, JE 2008, 'Application of discrete choice experiments to value multi-attribute health states for use in economic evaluation', 13th National Health Outcomes Conference, Canberra.
King, MT, Viney, RC, Norman, R, Cronin, PA, Street, D, Brazier, JE & Ratcliffe, J 2008, 'Valuation of EQ-5D health states using discrete choice experiments: effect of excluding implausible states', International Society for Quality of Life Research (ISOQOL) Conference, Montevideo, Uruguay.
King, M.T., Viney, R.C., Hossain, I., Smith, D., Fowler, S. & Savage, E.J. 2008, 'Men's preferences for treatment for early stage prostate cancer: results from a discrete choice experiment', 13th National Health Outcomes Conference, Canberra.
Viney, R.C., King, M.T., Savage, E.J. & Hossain, I. 2008, 'Quantifying the trade-off between quality of life and survival in prostate cancer: Results from a choice experiment', Centre for Applied Economics Research 5th Summer Workshop in Health Economics, UNSW, Sydney.
Fiebig, DG, Hossain, I & Viney, RC 2007, 'Decisions About Pap Tests: What Influences Women And Providers', iHEA 6th World Congress on Health Economics, Copenhagen, Denmark.
Mitchell, A. & Viney, R.C. 2007, 'Learning from experience: revision of the Australian Pharmaceutical Benefits Advisory Committee Guidelines', iHEA 6th World Congress on Health Economics, Copenhagen, Denmark.
Fiebig, DG, Haas, MR & Viney, RC 2007, 'Preferences for new and alternative cervical cancer screening technologies: Results from a discrete choice experiment with nested choices', Australian Conference of Health Economists, Brisbane.
King, MT, Smith, DP, Hossain, I, Fowler, S, Viney, RC & Armstrong, B 2007, 'Men's preferences for treatment of early stage prostate cancer: Results from a discrete choice experiment.', BJU International 2007: 99 (Suppl 2)., Urological Society of Australia and New Zealand, Blackwell Publishing, Adelaide, pp. 3-4.
Norman, R, Cronin, PA, Viney, RC, King, MT, Street, D, Brazier, JE & Ratcliffe, J 2007, 'Issues in the valuation of health using multi-attribute utility measures; the EQ-5D', Australian Conference of Health Economists, Brisbane.
Viney, R.C., Savage, E.J., King, M.T. & Hossain, I. 2007, 'Using choice experiments to estimate QALYs: An application to prostate cancer', iHEA 6th World Congress on Health Economics, Copenhagen, Denmark.
Van Gool, K, Gallego, G, Haas, MR, Hall, JP, Viney, RC, Ward, R, Links, M, Stewart, B, Board, N & Pearson, S 2006, 'Incorporating economic evidence into cancer care: searching for the missing link', Australian Conference of Health Economists, Perth.
Kenny, P.M., King, M.T., Viney, R.C., Boyer, M., Pollicino, C., McLean, J., McCaughan, B.C. & Fulham, M.J. 2004, 'Quality of life in the two years after surgery for non-small cell lung cancer', Quality of Life Research 2004; 13(9)., 11th Annual Conference of the International Society for Quality of Life Research, Springer, Hong Kong, pp. 1594-1594.
Kenny, P.M., King, M.T., Viney, R.C., Boyer, M., Pollicino, C., McLean, J., McCaughan, B.C. & Fulham, M.J. 2004, 'Quality of life in the two years after surgery for non-small cell lung cancer', 10th Annual National Health Outcomes Conference, Canberra.
Boyer, M., Viney, R.C., Fulham, M.J., King, M.T., McCaughn, B., Kenny, P.M., Pollicino, C. & McLean, J. 2001, 'A randomised trial of conventional staging (CS) with or without positron emission tomography (PET) in patients with stage 1 or 2 Non-Small Cell Lung Cancer', American Society of Clinical Oncology Conference, San Francisco.
Viney, RC, Pollicino, C, Haas, MR, King, MT & Kenny, PM 2001, 'Assessing the value of a PET scan for patients with non-small cell lung cancer', International Health Economics Association (iHEA) 3rd World Conference, York, UK.
Viney, R.C. 2001, 'Using stated preference discrete choice modelling to test the form of the utility function for health care', 23rd Australian Health Economics Society Conference, Canberra.
Harris, L. & Viney, R.C. 2001, 'Intra-faculty curriculum collaboration: costs and benefits', Ed-Health 2001: Collaboration for Quality Learning, inaugural College of Health Sciences Conference, University of Sydney.
Kenny, PM, Hall, JP, Viney, RC, Haas, MR & King, MT 2001, 'Validity of choice modelling for measuring consumer preferences in health', 2nd New Zealand Australia Health Services & Policy Research Conference, Wellington, NZ.
Lancsar, E., Van Gool, K., Viney, R.C. & Hall, J.P. 2001, 'Funds pooling in Australia: diving into the deep end', 2nd New Zealand Australia Health Services & Policy Research Conference, Wellington, NZ.
Pollicino, C, Haas, MR & Viney, RC 2001, 'Preferences and perceptions of patients with non-small cell lung cancer', 2nd New Zealand Australia Health Services & Policy Research Conference, Wellington, NZ.
Van Gool, K., Lancsar, E., Viney, R.C. & Hall, J.P. 2001, 'The Australian health care system: Where does it hurt?', 2nd New Zealand Australia Health Services & Policy Research Conference, Wellington, NZ.
De Abreu Lourenco, R, Haywood, P, Parkinson, B, van Gool, K & Viney, R CHERE 2015, The economic implications of a genomically guided approach to cancer: A report by the Centre for Health Economics Research and Evaluation for the Cancer Council, Sydney.
This report examines how genomically based approaches may also alter the way that new technologies are funded and adopted in the health care system. In particular, how they challenge the routine pathways by which technologies are diffused into routine practice. The report also focuses on how genomically guided technologies challenge current coverage decisions. It examines the economic evidence-base for assessing the cost and benefits of such technologies. In doing so, the report highlights the current limitations in this field of research as identified through a systematic review of recommendations made by Australian policy-makers, as well as through a review of the literature. This analysis is then used to develop a framework for economic evaluations with special reference to genomically based technologies. Finally, the report also identifies a number of key policy challenges for the efficient diffusion of genomically guided cancer care into the Australian health care system.
Reeve, R, Arora, S, Viney, R, Goodall, S, van Gool, K, Knox, S & Kenny, PM NSW Health 2014, Evaluation of NSW Health Drug and Alcohol Consultation Liaison Services. Report for the Mental Health Drug and Alcohol Office (MHDAO), North Sydney.View/Download from: UTS OPUS
Reeve, R.D., Hou, C. & Viney, R.C. CHERE 2013, Results of the evaluation of costs and consequences of TOP 5, Sydney.
Van Gool, K., Savage, E.J., Johar, M., Knox, S.A., Jones, G. & Viney, R.C. Commonwealth of Australia 2011, Extended Medicare Safety Net review of capping arrangements report 2011: a report by the Centre for Health Economics Research and Evaluation, pp. 1-130, Canberra.View/Download from: UTS OPUS
Savage, EJ, Van Gool, K, Haas, MR, Viney, RC & Vu, M Department of Health & Ageing 2009, Extended Medicare safety net review report 2009 : a report by CHERE prepared for the Australian Government Department of Health & Ageing, pp. 1-80, Canberra.
Haas, MR, Hall, JP, Gallego, G, Goodall, S, Norman, R, Van Gool, K & Viney, RC CHERE, University of Technology, Sydney 2008, Development of an evaluation framework and methodology for national blood supply change proposals: Final report, pp. 1-105, Sydney.
Haas, MR, Hall, JP, Gallego, G, Goodall, S, Norman, R, Van Gool, K & Viney, RC CHERE, University of Technology, Sydney 2008, Framework and methodology for national blood supply change proposals: Part 2, pp. 1-33, Sydney.
Warren, E & Viney, RC CHERE 2005, An economic evaluation of the prison methadone program in New South Wales, CHERE Project Report No 22, Sydney.
Viney, RC, De Abreau Lourenco, R, Kitcher, D & Gerard, K CHERE 2000, NSW breast and cervical screening program review, CHERE Project Report No 14, Sydney.
Haas, MR, Chapman, S, Viney, RC, Hall, JP & Ferguson, AC CHERE 1999, The news on health economics: a study of resource allocation in health in the Australian print media for 1996, CHERE Discussion Paper No 40, Sydney.
Haas, MR, Shanahan, M, Viney, RC & Cameron, I Commonwealth Department of Health and Ageing 1999, Consultancy to progress hospital in the home care provision: Final report, CHERE Project Report No 13, Canberra.
Mooney, G, Haas, MR, Viney, RC & Cooper, L CHERE 1997, Linking health outcomes to priority setting, planning and resource allocation - Report to the NSW Department of Health, CHERE Project Report No 1, Sydney.
Fiebig, D, Viney, RC, Haas, M, Knox, S, Street, D, Weisberg, E & Bateson, D 2015, 'Complexity and doctor choices when discussing contraceptives', Health, Econometrics and Data Group, University of York. WP15/14.View/Download from: UTS OPUS
While there is increasing evidence that group-based lifestyle-focussed interventions may provide more realistic, effective and cost-effective alternatives to intensive, individualised dietary counselling and exercise training, relatively little is known about individualsâ preferences for and perceptions of these programs. This paper reports the results of qualitative interviews conducted with participants of a lifestyle intervention trial (Shape up for LifeÂ© (SufL) aimed to improve body composition and metabolic health through long-term non-restrictive behaviour modification. Purposive sampling was used to identify 22 participants who participated in detailed interviews regarding their expectations of the intervention, perceptions of benefits and their experience post-intervention and capacity to maintain the lifestyle changes. The results indicate that in general participants are focussed on weight loss as a goal, even when the intervention offered and provided other benefits such as improved fitness and body shape and composition. The individuals who benefited most from the intervention typically had lower baseline knowledge about dietary and exercise guidelines. While the relatively non-restrictive nature of SufL provided flexibility for participants, many participants perceived that a more structured program may have assisted in achieving weight loss goals.
Johar, M, Fiebig, DG, Haas, MR & Viney, RC 2009, 'Evaluating changes in women's attitudes towards cervical screening following a screening promotion campaign and a free vaccination program. CHERE Working Paper 2009/3', CHERE Working Paper.
This study examines behavioural changes brought about by two interventions introduced to lower the incidence of cervical cancer in Australia. The first intervention is a media campaign promoting regular screening behaviour to women. The second intervention is a vaccination program providing a free HPV vaccine, Gardasil, to young women launched in the same period. The results using data from discrete choice experiments find that in general, given individual characteristics, the interventions have minor impact on how women value screening attributes. The interventions however alter womenâs inherent taste for screening. Unexpectedly, willingness to screen is generally lower post-interventions. The reason for this trend appears to be related to HPV events. For instance, the reduction in screening participation is particularly marked among young women who are eligible for the vaccination program. There is also a larger aversion towards testing among women who gained information on HPV facts and HPV-related measures. Thus, in the face of HPV innovations, screening promotions need to account for these factors. A simulation exercise is then performed to assess the plausibility of several strategies to increase the screening rate. The results nominate supply-side policies, in particular those targeted to health providers, as the most effective strategy.
Norman, R & Viney, RC 2008, 'The effect of discounting on quality of life valuation using the Time Trade-Off, CHERE Working Paper 2008/3'.
Despite the success internationally of cervical screening programs debate continues about optimal program design. This includes increasing participation rates among under-screened women, reducing unnecessary early re-screening, improving accuracy of and confidence in screening tests, and determining the cost-effectiveness of program parameters, such as type of screening test, screening interval and target group. For all these issues, information about consumer and provider preferences and insight into the potential impact of any change to program design on consumer and provider behaviour are essential inputs into evidence-based health policy decision making. This paper reports the results of discrete choice experiments to investigate womenâs choices and providersâ recommendations in relation to cervical screening in Australia. Separate experiments were conducted with women and general practitioners, with attributes selected to allow for investigation of interaction between womenâs and providersâ preferences and to determine how women and general practitioners differ in their preferences for common attributes. The results provide insight into the agency relationship in this context. Our results indicate a considerable commonality in preferences but the alignment was not complete. Women put relatively more weight on cost, chance of a false positive and if the recommended screening interval were changed to one year.
Van Gool, K, Gallego, G, Haas, MR, Viney, RC, Hall, JP & Ward, R 2007, 'Incorporating economic evidence into cancer care: searching for the missing link, CHERE Working Paper 2007/3', CHERE Working Paper.
King, MT, Winstanley, J, Kenny, PM, Viney, RC, Zapart, S & Boyer, M 2007, 'Validity, reliability and responsiveness of the EORTC QLQ-C30 and the EORTC QLQ-LC13 in Australians with early stage non-small cell lung cancer, CHERE Working Paper 2007/13', CHERE Working Paper.
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The aims of this paper are: to review and describe different approaches to HTA used in Australia and in other countries and to identify the features of best practice in HTA, particularly those likely to be most relevant to HTA at a local (ie state/regional) level.
There are a number of well-developed models of HTA at the national and local levels. Most information about the operation of these models, particularly about the type and number of evaluations conducted, the recommendations/decisions made and the reasons for these is available for national processes, but there is much less readily available documentation about local level HTA. Most HTA processes that operate nationally and internationally can be categorised in one of three ways: guidance (provides structured information about appropriate technologies), mandatory (provides mandatory information about technologies to be implemented) and funding and implementation (provides structured evidence-based advice about which technologies should be implemented, the level of funding required to implement them and the source of these funds).
The main factors which distinguish a high quality HTA process are that i) it is efficient in terms of setting priorities, the scope of the technologies to be assessed, avoidance of duplication and overall cost of the process, ii) the overall impact on utilisation and health budget is calculated as part of the HTA and iii) procedural justice occurs and is seen to occur; iv) it includes a comprehensive assessment of the impact on issues such as workforce, credentialing of providers and the ethical dimension of the technology; v) it influences decision making by being communicated appropriately and using trusted methods; vi) it influences adoption and diffusion of technology by ensuring that there is no diffusion prior to HTA, the results are incorporated into guidelines or recommendations, funding is linked to the decision, and remuneration arrangements and other characteristics o...