Pickin, M., Cooper, C.L., Chater, T., O'Hagan, A., Abrams, K.R., Cooper, N.J., Boggild, M., Palace, J., Ebers, G., Chilcott, J., Tappenden, P. and Nicholl, J. (2009) The multiple sclerosis risk sharing scheme monitoring study - early results and lessons for the future. BMC Neurology, 9. Art. No.1. ISSN 1471-2377
Background: Risk sharing schemes represent an innovative and important approach to the problems of rationing and achieving cost-effectiveness in high cost or controversial health interventions. This study aimed to assess the feasibility of risk sharing schemes, looking at long term clinical outcomes, to determine the price at which high cost treatments would be acceptable to the NHS.
Methods: This case study of the first NHS risk sharing scheme, a long term prospective cohort study of beta interferon and glatiramer acetate in multiple sclerosis ( MS) patients in 71 specialist MS centres in UK NHS hospitals, recruited adults with relapsing forms of MS, meeting Association of British Neurologists (ABN) criteria for disease modifying therapy. Outcome measures were: success of recruitment and follow up over the first three years, analysis of baseline and initial follow up data and the prospect of estimating the long term cost-effectiveness of these treatments.
Results: Centres consented 5560 patients. Of the 4240 patients who had been in the study for a least one year, annual review data were available for 3730 (88.0%). Of the patients who had been in the study for at least two years and three years, subsequent annual review data were available for 2055 (78.5%) and 265 (71.8%) patients respectively. Baseline characteristics and a small but statistically significant progression of disease were similar to those reported in previous pivotal studies.
Conclusion: Successful recruitment, follow up and early data analysis suggest that risk sharing schemes should be able to deliver their objectives. However, important issues of analysis, and political and commercial conflicts of interest still need to be addressed.
|Copyright, Publisher and Additional Information:||© 2009 Pickin et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.|
|Institution:||The University of Sheffield|
|Academic Units:||The University of Sheffield > Faculty of Science (Sheffield) > School of Mathematics and Statistics (Sheffield)
The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > Medical Care Research Unit (Sheffield)
The University of Sheffield > University of Sheffield Research Centres and Institutes > Medical Care Research Unit (Sheffield)
The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > Health Economics and Decision Science
|Depositing User:||Miss Anthea Tucker|
|Date Deposited:||26 Jun 2009 08:37|
|Last Modified:||18 Nov 2015 22:19|