Over the last few years the Fit for Work Europe Coalition has been advocating the inclusion of ‘work’ of Health Technology Assessment (HTA) and other health economic evaluations – you may remember our discussion paper from 2011, authored by Steve Bevan and Leela Barham. But when it comes to ‘work’, what do we actually mean? Helping people return to the labour market, and contributing to measures of productivity, has always been a few focus of ours. It is important to remember, however, that work can include formal and paid, as well as informal and unpaid. Plus, we know from our research that work can also contribute to positive health outcomes.
Given that helping people return to work is not only good for health, but can also contribute positively to economic wellbeing, how can we include it in health investment decisions? This is a complex area. Currently, we need to address the ‘unreality of economic theory’ – helping develop practical guidance on how to operationalise including work, as well as a wider societal perspective, in HTA and other health economic evaluations. There is broad agreement that a wider societal perspective should be included when making investment decisions, from the macro (financial allocations to different Government departments) to micro level (financial allocations to individual services, drugs and devices), but exactly how is another matter…
Another complicated challenge for including work in those decisions, which we need to better understand, is the ‘operational costs’. If a service, drug or device is deemed to be cost effective, partly because of its wider societal benefits, then it is worth investing in, right? But, where in the budget does the money come from to pay for this? What resources may fall out of the budget to accommodate for the new intervention? And how much money will that loss cost?
Needless to say, answers to these questions, and many more, will not be found quickly. But in 2012 we are working to move this debate forward, and inform decision-makers about inclusion of work and a wider societal perspective in their investment decisions. Later this year we will be releasing our latest insights and position on the matter, utilising some of our expert supporters to help ensure work & health together are moving towards to the top of the decision-maker’s agenda.