Dr Rohan Sweeney
- ARC Discovery Early Career Researcher Award (DECRA) Fellowship - Maximising impacts of aid for health by incorporating local priorities
This project aims to increase the effectiveness of Australia’s health aid program in the Asia-Pacific region by employing health economics methods and working with stellar international collaborators.
Australia has committed to better align health aid with recipient priorities, however, there is a need for evidence on how best to achieve this.
This project will provide urgently needed evidence for the Australian Government and NGO community on (i) where health aid funding is not aligned with recipient priorities in the Asia Pacific region, (ii) the extent that increased alignment could impact on the effectiveness of health aid, and (iii) strategies to improve the alignment of donor and recipient health aid priorities.
This project expects to generate new knowledge about the benefits from increased alignment. Expected outcomes include increased regional research capacity and strategies for stakeholders to increase alignment for greater impact. It aims to benefit Australia’s health aid program, so that it meets the expectations of the Australian public and Government and improves the health and wellbeing of aid beneficiaries.
Associate Professor Dennis Petrie
- Department of Health MRFF – Epidemiological modelling to deliver better care for Australian patients with myeloma (EpiMAP Myeloma) with Laura Fanning, Anthony Harris and Adam Irving.
This is a collaborative project with A/Professor Zoe McQuilten, Professor Erica Wood and Professor Andrew Spencer from the School of Public Health and Preventive Medicine.
Our project will develop and validate a novel patient-level simulation model to estimate patients in Australia with multiple myeloma (MM) who will require treatment over the next five years, and their associated quality of life and costs.
The model will use real world data from the Myeloma and Related Diseases Registry linked to Commonwealth administrative data, be validated with international evidence, and utilise unique modelling applicable to MM disease trajectories and outcomes.
The project will address a critical knowledge gap in MM, as the current prevalence and future incidence of MM in Australia is unknown, the treatment pathway for MM is highly complex and there is a host of emerging therapeutics which will continue to escalate treatment complexity and costs, and clinical trials are rarely generalisable to the broader MM population.
The model will be available for use in Commonwealth decision making for future funding of high-cost therapies for MM.
- World Health Organisation Consultancy Grant – Financial protection, universal health coverage and health care use, with Samia Badji, Dennis Petrie and Karinna Saxby.
This collaborative project with the WHO aims to understand the level of financial protection from ill-health in Australia. We use Australian health expenditure data to:
- Monitor catastrophic and impoverishing health spending in Australian households.
- Investigate how out-of-pocket costs for medical care have changed from 2009-10 to 2015-16.
- Describe how out-of-pocket costs for medical care vary by age, gender, concession card status and private health insurance status.
- Explore whether safety nets and rurality (as a proxy for access to healthcare) affect medical expenditure
- Economic Evaluation for PROSPECT – Dennis Petrie and Karinna Saxby
To determine the potential cost-effectiveness of implementing a protocol where women with Early Stage Breast Cancer undergo a pre-surgical MRI (and for those women where the MRI clearly shows no synchronous cancer lesions radiotherapy is omitted) compared to standard practice (no MRI and all women receive radiotherapy).
Dr Laura Fanning
- MRFF - Griffith University led. Quality, Safety and Effectiveness of Medicine Use and Medicine Intervention by Pharmacists – with Dennis Petrie
Associate Professor Dennis Petrie and Dr Laura Fanning from Monash University’s Centre for Health Economics, are collaborating on a new $2.5 million Medical Research Future Fund project co-led by Dr Jean Spinks (Griffith University), a former staff member and PhD student at the Centre for Health Economics, and Professor Lisa Nissen (QUT).
The aim of the project is to decrease the number of medication-related problems and hospital admissions in Australia. Serious medication-related problems can lead to a range of life-threatening issues such as haemorrhage, exacerbation of heart failure, renal failure or acute asthma, causing unplanned hospitalisations, costly health complications, and even death.
Pharmacists, working collaboratively with GPs, Primary Health Networks and Aboriginal Community Controlled Health Organisations (ACCHO’s), will systematically address issues such as under prescribing, over prescribing or incomplete therapeutic monitoring.
The three-year collaborative trial will use health record data to automate the detection of medication safety issues before harm occurs.
Other important aspects of the trial will include the co-design of the intervention with both consumers and health practitioners, the evaluation and refinement of incentive payments for health workforce engagement, and a particular focus on Aboriginal and Torres Strait Islander people, who use a lot of medication for chronic disease and may have reduced access to healthcare.
This collaborative study also includes partners from the Department of General Practice, Melbourne University, the Australian Digital Health Agency, Brisbane South Primary Health Network, the National Aboriginal Community Controlled Health Organisation (NACCHO), MedAdvisor, the Pharmaceutical Society of Australia and the Pharmacy Guild of Australia.
- MRFF grant: Addressing unmet needs for patients with blood cancers: Immunoglobulin or antibiotics to prevent infection in the RATIONALISE clinical trial with Dennis Petrie
Dr Laura Fanning and Associate Professor Dennis Petrie from the Centre for Health Economics will work collaboratively with Professor Erica Wood and her team from the Transfusion Unit at the School of Public Health and Preventive Medicine on the MRFF funded- RATIONALISE clinical trial.
Patients with blood cancers, with immune deficiency from low antibody levels and disease or treatment factors, are at risk of life-threatening infections. Immunoglobulins (Ig) made from plasma can supplement antibody levels.
Government criteria recommend stopping Ig therapy in stable patients, but with no evidence for when or how to do so.
The RATIONALISE trial will provide new evidence to improve patient outcomes, reduce infection risks and costs and make better use of blood products for the community. Alongside generating important clinical data, within trial and modelled post-trial health economic analyses will be undertaken to assess net costs and benefits of continuing Ig or switching to antibiotic prophylaxis. A discrete choice experiment will also inform how patients value reducing infection risk and their preferences for different treatment choices.
Professor Anthony Harris
- Medibank Grant: "CareOA" linking Australians with specialised knee osteoarthritis treatment and support across the osteoarthritis trajectory
A three-arm pragmatic randomised controlled trial (RCT) in 415 Medibank members from around Australia who have clinical knee OA and are overweight/obese, the trial will compare the effectiveness and cost-effectiveness of two knee OA services (CareOA and CareOA-Plus) to usual care on the primary outcomes of pain and function.
A range of secondary outcomes will be assessed; including rates of referral to an orthopaedic surgeon. Outcomes will be measured at baseline, 6 months and 12 months.
A concurrent non-randomised observational cohort will be established to compare outcomes of members participating in the CareOA services to those taking part in the existing Medibank-funded OA Healthy Weight for Life (HWFL) program. To our knowledge, this will be the first trial in the world to look at long-term surgical outcomes of such an osteoarthritis management program.
- NHMRC Sculptor Clinical trials
Knee osteoarthritis (KOA) is a highly prevalent disabling joint disease affecting 37% of people 60 years of age or older. It has no cure and often leads to costly joint replacement. Intra-articular stem cell therapy is increasingly being utilised for treating KOA with little high quality evidence to support their use. The aim of this study is to investigate the effectiveness and cost effectiveness of allogeneic mesenchymal stem cells (MSCs) on medial tibiofemoral KOA-related clinical outcomes and knee joint structure over 24 months.
The SCUlpTOR study is a phase III, multi-centre, parallel, superiority, randomised, double-blind, placebo-controlled, two-arm clinical trial, which will be conducted in Sydney and Hobart (Australia) over five years. 440 participants (220 per arm) aged over 40 years with painful Knee Osteoarthritis will be recruited from the community and randomly allocated to receive either intra-articular MSCs injections or intra-articular saline injections at baseline, week 3 and 52. The primary outcome will be the proportion of participants achieving patient-acceptable symptom state (PASS) for knee pain at 24 months and central medial femorotibial (cMFT) cartilage thickness change from baseline to 24 months. Quality of life is measured by the reported AQoL-8D utility scores translated into quality adjusted life year equivalents.
- NHMRC MRFF - PPHR Initiative - 2020 Maternal First 2000 Days and Childhood Health HipHealth: an exercise and weight loss telehealth program to improve outcomes for Australians living with hip osteoarthritis
This project aims to improve the health and well-being of Australians with hip OA through changes in delivery of, and access to, exercise and nutrition healthcare services. Clinical guidelines emphasise education, exercise and weight loss as core treatments for people with hip OA, yet 57% do not receive appropriate care. Australia is one of the world's largest consumers of costly hip joint replacement, with 77% performed in people with overweight/obesity and 60% in the private sector. We have developed and pilot-tested an innovative 6-month telehealth program (HipHealth) for painful hip OA. This project aims to evaluate: 1) clinical and cost-effectiveness of HipHealth compared to usual care in 212 people with hip OA at 6, 12, and 24 months; and 2) HipHealth implementation and barriers/facilitators to scale-up from perspectives of patients, clinicians and other end users. We have a ready path to immediate scale up by Medibank if HipHealth is effective, with a realistic and feasible knowledge translation plan for its implementation in other primary and public healthcare settings. We will also develop online training resources for clinicians and make them freely available to build workforce capacity.
Associate Professor Gang Chen
- National Disability Insurance Scheme (NDIS) grant - jointly with Dennis Petrie and Anthony Harris.
Developing A Preference-based Wellbeing Index to Facilitate Resource Prioritisation in National Disability Insurance Scheme: The NDIS Wellbeing Index
This grant will aim to develop and validate a preference-based wellbeing index that can estimate the benefits and thus the cost-effectiveness of investments for people with disabilities. Constructing a classification system for a new NDIS Wellbeing Index that encompasses all eight NDIS outcome domains, and leverages the existing short-form outcomes framework questionnaire to the maximum extent possible.
- MRFF Preventive and Public Health Research grant
Measuring and Valuing Changes in Child Health to Facilitate Robust Decision Making jointly with the QUOKKA Team (Quality of Life in Kids, www.quokkaresearchprogram.org)
Associate Professor Gang Chen is co-leading part of the project to strengthen self-report and proxy-reported measurement of paediatric health-related quality of life (HRQoL) and to produce a paediatric HRQoL value set for Australia.
Congratulations to the Health Technology Assessment (HTA) team for receiving the 2020 Dean’s Commendation for Research Impact. The team now has seven core members with Dr Nicola Huxley formally joining after completing her PhD. Recent renewal of a $6 million dollar contract with the Department of Health also means we are looking to recruit more team members to work across HTA and related research. If you are interested to join the team, please contact Team Leader Jing Jing Li for a confidential discussion.
2021 also marks the 20th year that our HTA group has provided evaluations reports to the Pharmaceutical Benefits and the Medical Services Advisory Committees (PBAC and MSAC) giving advice on whether a new health technology should be funded and at what price. An important milestone especially since Australia was also the first country in the world to require formal cost effectiveness analyses to support drug subsidy decisions and our group has been there from the very beginning. A very proud moment for the HTA team and the CHE. The advice provided by us to the government on cost and benefits of new technologies has directly resulted in successful funding of needed treatments for patients with a combined annual expenditure of approximately $1 billion per annum. Just as important, the evidence that we have provided also excluded funding of low value treatments with savings of over $2.5 billion dollars per annum for treatments that would be poor value for money for our society.
In an effort to diversify and expand capabilities within the group, the team will be continuingly looking out for interesting projects in 2022 and beyond. We are also planning to host a HTA workshop early in 2022. Please complete this online form if you would like us to keep in touch with the details.