Health Economics

Coordinators: Dr. Toni Mora

One of the strategic approaches of the IRAPP is the economic evaluation of a wide range of technologies used in clinical and health services. This is based on a double objective: to provide applied and relevant research for policies, while methods to increase the rigor and relevance of these studies are developed and perfected. This strategy is highly significant since economic evaluation holds an increasingly influential role in international and national policies on the adoption and use of healthcare resources.

In the same way, the use of applied microeconomics is fundamental in terms of the evaluation of public policies since it introduces the main methods currently used to assess programmes. Linking the assessment of a programme to economic theory is the key element to ensure you can undertake an assessment of the impact of public policies from an economic point of view. This analysis of their impact can involve an economic or applied micro-econometric assessment or a combination of both types of analysis.

• Title: Real World Evidence Chair 

Completion date: 2020

Description: The main research lines for this chair focus on: studying drug adherence for the treatment of various diseases, as well as examining any relationship with the severity of the disease; evaluating costs and budgetary impact; and finally, defining the treatment pathway for diseases based on real-world data, comparing recommendations from clinical practice guidelines with the actual treatment patients receive. 

• Title: The impact of alternative interventions on food decisions: food cash-aid beneficiaries (Redcrosscards) (Recerca Social ‘la Caixa’)”

Completion date: 2021

RESEARCH TEAM Toni Mora (co-PI), Eleonora Fichera, Beatriz González, Blanca Raido and Pedro Rey.

Description: The main objective of this project is to ensure that people benefiting from financial aid improve their purchasing patterns in terms of nutritional content. The impact of alternative public health policies, aimed at correcting the nutritional habits of the population with less financial resources, is analysed and verified in this project.

• Title: Data analysis for the ALERTA/FRÁGIL programme: Costs and outcome of home care measures

Completion date: 2019

Research team Marta Troimplement-Bertran (co-PI), Toni Mora Corral, Irene Sánchez Collado, David Roche Valles.

Description: The objective of this project is to assess the impact on health outcomes and the use of resources before and after two monitoring programmes (ALERTA and FRÁGIL) and to compare them with health outcomes and the use of resources for group control (trying to compare them to achieve a potential comparison of the two groups and a future financial assessment). The three patient groups and the costs and benefits of each group have to be analysed. The potential for developing a future financial assessment will also be explored.

• Title: Price and refund system for combinations with more than one indicator

Description: This project’s main objective is to analyse the different options available to better inform people about the procedures involved in funding and pricing a drug combination, especially for expensive medication, which involves the same or a new indication financed by the Public Health System.

In order to fulfil this objective, it is first necessary to reach three sub-objectives:

Objective 1: To understand the behaviour of price regulation in Spain when authorisations are granted for new indications that increase the value of a medicine used in a drug combination.

Objective 2: To understand which categories of price fixation and access conditions are foreseen on an international scale for new authorised drug combinations.  

Objective 3: To create an Advisory Board to identify current problems regarding price regulation when price increases of medicines used in combination occur, as well as regarding the feasibility and willingness to bring about the regulatory changes that are deemed appropriate.

• Title: The economic burden of Alzheimer's disease in Catalonia

Completion date: 2023

Research team Toni Mora (co-PI)

Description: Evaluation of the number of patients with Alzheimer's disease in Catalonia, trying to make estimates in Spain and calculating the average annual cost per patient and annual cost (direct medical care and non-direct care costs) of Alzheimer's disease if the different stages of the disease are taken into consideration.

• Title: Nutrition research project in retirement homes and day centres (NUTRIRAS)

Completion date: 2021

Research team Toni Mora (co-PI)

Description: An evaluation of the effectiveness and efficiency of educational programmes regarding nutrition in older people in institutions, focusing particularly on the improvement of the quantity of food intake with and without modified textures.

• Title: Inequalities in the treatment of ADHD in Catalonia

Completion date: 2021

Research team Toni Mora and Jordi Cid (IAS).

Description: The general objective of this study is to analyse the variability in ADHD treatment across Catalonia. Other more specific objectives are also outlined:

• To study the variability in the treatment of ADHD disorders in the patterns of mental health resource consumption and treatment of people who have been diagnosed with ADHD and are in treatment, taking into account both the intensity and type of combined treatment.

• To determine whether the provider or facility providing care has an effect on the variability of care. 

• To observe variability by geographic area.

• Links to family intervention and how this intervention may reduce or increase treatment. 

• Differences in cost depending on the type of treatment or the combination of family care.

• Impact of the financial crisis and the new co-payment system on the consumption of medication and the number of visits.

• Long-term consequences on the labour market despite being conditioned by the length of the time series obtained. 

• Possible impact on academic performance depending on the treatment.

• Occurrence of criminality by people with ADHD.

• Title: Unhealthy lifestyles: tools for health policy analysis

Completion date: 2021

Research team Toni Mora Corral (co-PI), David Roche Valles, Marta Tromón-Bertran, Ángel López Nicolás, Jaume Puig Junoy, Joan Ramon Villalbí Hereter.

Description: The projects specific objectives are: To undertake an economic evaluation of programmes or interventions to reduce passive smoking by measuring the direct health costs borne by the National Healthcare System. 

• To identify the determining factors of the health of adolescent alcohol consumers in Spain through micro-econometric models, taking into account the causality and social interactions among this population. 

• To undertake an economic evaluation of a programme to reduce the consumption of alcohol, evaluating whether there was a return on the investment of public money in terms of healthcare. 

• To quantify the economic burden of heroin users in Catalonia, taking into account the direct costs on healthcare.

• To evaluate the efficiency, in terms of costs and effectiveness, of new heroin consumption assisted treatment in Catalonia in street centres for drug addicts. 

• To design and carry out a qualitative analysis of older people’s eating habits in centres for the elderly. 

• To evaluate, from an efficiency point of view, a programme or intervention that corrects malnutrition in geriatric residences and, as a consequence, reduces the strain on the population’s health resources. 

•  To determine the effectiveness of the tax on sugary drinks, approved in Catalonia in March 2017, based on sales data.

Institutional reference number: ECO2017-83771-C3-3-R Ministry of the Economy, Industry and Competitiveness (MINECO), State Research Agency (IEE) and European Regional Development Fund (ERDF).

• Title: User-demand for medication 

Description: There is a group of disadvantaged people in our society who need to choose between food and medication. There are many Spanish citizens who do not have enough resources to buy the medication they need. This project aims to analyse the demand for this medication, the socio-demographic variables it depends on and the different user profiles who have these needs in our society.

• Title: Methodological and statistical study of the consumption of healthcare resources. Comparison before and after attending the hospital and receiving at-home care. Private study of the specific impact of the nutritional aspects.

Completion date: 2019

Research team Toni Mora (co-PI)

Description: The general objective is to evaluate the methodological and statistical study of a project developed by NUTRICIA Spain for a hospital in Valencia. This study aims to analyse the consumption of healthcare resources based on two situations where the patient experiences a period of hospital care and another of care at home. The objective of the comparison of healthcare resources consumed and the impact of numerous variables that can explain the differences before and after attending the hospital or receiving at-home care. Specifically the impact on or relationship between the concept that is the subject of the study and nutrition.

• Title: Does a decrease in the generosity of unemployment benefits make health worse? Evidence from a natural experiment in Spain

Research team Manuel Flores.

Description: The objective of this project is to study the causal effect of the generosity of unemployment benefit on the health of individuals after a reform of the labour market, which is used as a natural experiment.

• Title: Financial burden of Amyotrophic Lateral Multiple Sclerosis 

Completion date: 2023

Research team: Toni Mora (co-PI)

Description: This study aims to evaluate the economic burden that this disease generates, taking into account the direct healthcare costs and the direct non-healthcare costs and well as a loss of productivity.