Health Economics Research Group, Brunel University London, Uxbridge, United Kingdom.
Policy Institute at King's, King's College London, Virginia Woolf Building, 22 Kingsway, London, WC2B 6LE, United Kingdom.
Health Res Policy Syst. 2018 Jan 10;16(1):1. doi: 10.1186/s12961-017-0276-7.
Building on an approach applied to cardiovascular and cancer research, we estimated the economic returns from United Kingdom public- and charitable-funded musculoskeletal disease (MSD) research that arise from the net value of the improved health outcomes in the United Kingdom.
To calculate the economic returns from MSD-related research in the United Kingdom, we estimated (1) the public and charitable expenditure on MSD-related research in the United Kingdom between 1970 and 2013; (2) the net monetary benefit (NMB), derived from the health benefit in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of £25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1994 to 2013; (3) the proportion of NMB attributable to United Kingdom research; and (4) the elapsed time between research funding and health gain. The data collected from these four key elements were used to estimate the internal rate of return (IRR) from MSD-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using a one-way sensitivity analysis.
Expressed in 2013 prices, total expenditure on MSD-related research from 1970 to 2013 was £3.5 billion, and for the period used to estimate the rate of return, 1978-1997, was £1.4 billion. Over the period 1994-2013 the key interventions analysed produced 871,000 QALYs with a NMB of £16 billion, allowing for the net NHS costs resulting from them and valuing a QALY at £25,000. The proportion of benefit attributable to United Kingdom research was 30% and the elapsed time between funding and impact of MSD treatments was 16 years. Our best estimate of the IRR from MSD-related research was 7%, which is similar to the 9% for CVD and 10% for cancer research.
Our estimate of the IRR from the net health gain to public and charitable funding of MSD-related research in the United Kingdom is substantial, and justifies the research investments made between 1978 and 1997. We also demonstrated the applicability of the approach previously used in assessing the returns from cardiovascular and cancer research. Inevitably, with a study of this kind, there are a number of important assumptions and caveats that we highlight, and these can inform future research.
基于应用于心血管疾病和癌症研究的方法，我们估算了英国公共和慈善资助的肌肉骨骼疾病（MSD）研究的经济回报，这些回报来自英国改善健康状况的净价值。
为了计算英国与 MSD 相关研究的经济回报，我们估算了（1）1970 年至 2013 年英国与 MSD 相关研究的公共和慈善支出；（2）从 1994 年至 2013 年，从优先干预措施中获得的健康效益（以质量调整生命年（QALYs）衡量，并以 QALY 价值 25,000 英镑的基础案例价值货币化）减去提供该效益的成本，为 1994 年至 2013 年的优先干预措施计算的净货币效益（NMB）；（3）NMB 归因于英国研究的比例；（4）研究资金和健康收益之间的时间间隔。从这四个关键要素收集的数据用于估算 MSD 相关研究投资对健康收益的内部收益率（IRR）。我们使用单向敏感性分析分析了 IRR 估计的不确定性。
以 2013 年价格表示，1970 年至 2013 年与 MSD 相关的研究总支出为 35 亿英镑，用于估计回报率的时期（1978-1997 年）为 14 亿英镑。在 1994 年至 2013 年期间，分析的关键干预措施产生了 871,000 个 QALYs，NMB 为 160 亿英镑，考虑到由此产生的 NHS 净成本，并以 25,000 英镑的价格对 QALY 进行了估值。受益归因于英国研究的比例为 30%，MSD 治疗的资金投入和影响之间的时间间隔为 16 年。我们对 MSD 相关研究的内部收益率的最佳估计为 7%，与心血管疾病的 9%和癌症研究的 10%相似。
我们对英国公共和慈善资助的 MSD 相关研究的净健康收益的内部收益率的估计是可观的，这证明了 1978 年至 1997 年期间进行的研究投资是合理的。我们还展示了以前用于评估心血管疾病和癌症研究回报的方法的适用性。不可避免的是，对于这样的研究，我们强调了一些重要的假设和注意事项，这些可以为未来的研究提供信息。
