Extending The Australian Arm Of The International Tobacco Control Policy Evaluation Study
Funder
National Health and Medical Research Council
Funding Amount
$881,295.00
Summary
This project is to provide for the Australian arm of a large multi-national study to determine how tobacco control policies work. It is being conducted in the context of the implementation in 2005 of the World Health Organisation's Framework Convention on Tobacco Control, to which Australia is a party. We will provide new knowledge on the impacts of specific policies which are being implemented in Australia, as well as ones that occur in other countries that are part of the larger study. These i ....This project is to provide for the Australian arm of a large multi-national study to determine how tobacco control policies work. It is being conducted in the context of the implementation in 2005 of the World Health Organisation's Framework Convention on Tobacco Control, to which Australia is a party. We will provide new knowledge on the impacts of specific policies which are being implemented in Australia, as well as ones that occur in other countries that are part of the larger study. These include the adoption of graphic health warnings on tobacco packaging, removal of misleading constituents levels information from packs, bans of misleading descriptors such as Light and Mild, and implementation of smoke-free bars. In addition it will advance our understanding of how policy effects persist over time, their equity, and the means by which they contribute to increased cessation and reduced relapse. We do this by following smokers every year in each of the countries and asking them about their thinking and actions with regard to smoking, as well as about their awareness of the policies. By comparing the responses of smokers exposed to policies with those from other countries that are not exposed, we can work out the contribution of the policies to changes in smoking. Understanding policy effects on smokers and smoking cessation will lead to improved policies in Australia and the likelihood of improved dissemination of policies that work here to other countries. Similarly policies found to work in other countries, can be best adapted to Australia if we understand how they work. Taken in total, it should advance our efforts to reduce the burden of smoking-related harm both in Australia and the rest of the world.Read moreRead less
An Econometric Investigation Of Harmful Drinking And Price Response By Alcoholic Types To Inform Alcohol Tax Policies
Funder
National Health and Medical Research Council
Funding Amount
$449,157.00
Summary
This study will quantify the price responsiveness of alcohol consumption by types of alcoholic drinks and patterns of use, and the association of harmful drinking with physical and mental health. These estimates will then be used to analyse the impacts of a range of alcohol tax policies and education programs, and potential flow-on effects on health and other drug use, providing a guide to future alcohol policy.
EFFECTIVENESS OF INFLUENZA AND PNEUMOCOCCAL VACCINATION IN PREVENTING HOSPITALISATION DUE TO PNEUMONIA IN OLDER PERSONS
Funder
National Health and Medical Research Council
Funding Amount
$258,475.00
Summary
Flu and pneumococcus remain important causes of illness and death in Australia. They can cause pneumonia and severe respiratory illness, including death, especially in older people. This is because natural immunity against infections tends to decrease with age. Vaccination against flu and pneumococcus is therefore recommended for all persons aged 65 years or older, but only in Victoria are both vaccines publicly funded. The Victorian initiative appears to have had a marked impact on improving va ....Flu and pneumococcus remain important causes of illness and death in Australia. They can cause pneumonia and severe respiratory illness, including death, especially in older people. This is because natural immunity against infections tends to decrease with age. Vaccination against flu and pneumococcus is therefore recommended for all persons aged 65 years or older, but only in Victoria are both vaccines publicly funded. The Victorian initiative appears to have had a marked impact on improving vaccination coverage, but its impact on disease has never been assessed. This study will estimate vaccination coverage, missed vaccination opportunities, effectiveness of flu and pneumococcal vaccines in preventing hospitalisation for pneumonia, and cost-effectiveness of the currently funded vaccination program in this age group. This is considered a priority because of the serious but preventable nature of the diseases caused by these infections. This study will improve awareness of the importance of vaccination among individuals, and given the high estimated vaccine coverage in older Victorians, is well placed to provide the first available evidence for or against effectiveness and cost-effectiveness of flu and pneumococcal vaccination in older Australians. The results may have major implications for public health policy in Victoria and elsewhere in Australia.Read moreRead less
Modelling And Economic Evaluation Of Hepatitis C Epidemic Mitigation Strategies In Australia
Funder
National Health and Medical Research Council
Funding Amount
$465,132.00
Summary
To evaluate the impact of introducing hepatitis C virus (HCV) prevention and treatment strategies on the burden of hepatitis C in Australia through mathematical transmission models and health economics approaches. We will compare the impact of a peer-education intervention, preventive HCV candidate vaccines and enhanced HCV treatment initiatives in various risk groups on the number of HCV cases, HCV-related liver failure, liver cancer and transplants prevented, and associated cost savings.
Empirical Ethics: Quantification Of Social Preferences For Economic Evaluation In The Health Sector
Funder
National Health and Medical Research Council
Funding Amount
$329,450.00
Summary
Recent studies indicate that there are significant differences between the social 'preferences'-priorities of the population and the priorities implied by health policy and embodied in health economic evaluations of the health sector. For example, members of the public give higher priority to the severely ill even when little can be done for them. The studies suggest that the public would also take into account, inter alia, a number of other factors, including prognosis, health potential and the ....Recent studies indicate that there are significant differences between the social 'preferences'-priorities of the population and the priorities implied by health policy and embodied in health economic evaluations of the health sector. For example, members of the public give higher priority to the severely ill even when little can be done for them. The studies suggest that the public would also take into account, inter alia, a number of other factors, including prognosis, health potential and the social context of the problem. They would not treat program costs in the way economic theory and practice recommends. These issues have been dramatised in the WHO's Evaluation of Health Systems (World Health Report 2000). This assigns a weight of only 0.25 to health improvement and 0.75 to issues of fairness. The proposed study will carry out three tasks. The first is to measure the importance of Australian health-related social preferences which should, potentially, be included in economic evaluation studies. Key values - parameters - including the rate of time preference and the social willingness to pay for an additional year of life will be measured precisely for immediate use. Secondly, the importance of other issues including illness severity, adaptation and prognosis will be tested to determine how these factors should be included in the economic evaluation of health programs. Finally, some general issues related to public versus private funding, egalitarianism and choice will be investigated. Results from interviews and surveys will be integrated in the Assessment of Quality of Life (AQoL) instrument and its user manual.Read moreRead less
Economic Evaluation Of The Costs And Benefits Of Options For Publicly Funded Dental Care Provision In Australia
Funder
National Health and Medical Research Council
Funding Amount
$219,135.00
Summary
Governments and administrators of public dental services (PDS) currently address resource allocation problems with little guidance from the public. This project will provide evidence of population priorities that can underpin planning for public dental care and provide direction for priorities in PDS A cost-benefit analysis of dental care, to guide future decisions, will be conducted by comparing the community's willingness to pay for dental services and the cost of providing those services.
Obesity, Overweight And Hospitalisation: Identifying Targets For Interventions To Prevent Adverse Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$603,755.00
Summary
Obesity is an important and rapidly increasing health problem, especially in indigenous communities. The proposed project investigates how obesity affects the risk of hospital admission in Indigenous and non-Indigenous Australians, including providing evidence regarding the nature of the hospitalisation, the cost and whether specific groups are at a higher risk of obesity-related hospitalisation. In doing so it aims to identify targets for intervention to reduce obesity-related hospitalisation
Consumer Co-payments For Subsidised Medicines: Impact On Access And Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$465,838.00
Summary
Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and di ....Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and discretionary medicines fell immediately after the introduction of copayments for concessional card holders in 1991(5). Subsequent analysis found that low income general beneficiaries bore the greatest burden of copayments, with PBS expenditure accounting for 7.4% of their income, compared with 2.4% for those with high incomes(6). Costs appear to be becoming a barrier to medicine use in Australia, with a 2005 survey of 702 Australian adults who required regular medications finding 22% did not fill a prescription because of cost in the last 2 years(7). Similar results were reported in 2002 for 23% of 844 sicker Australian adults(8). A regional survey of 420 households found 20% reported they did not purchase all of their prescription medicines due to costs(9). Apart from the initial analysis of medication changes in 1991 as a result of copayment introduction(5), no Australian study has assessed the impact of these on medication use, nor on the impact of any changes in medication use on health outcomes. While copayments may effectively reduce the cost burden of the PBS to government, they may have an unintended negative effect if costs are generated elsewhere in the health system through increased hospitalisations or emergency department attendances as a result of omission of medicines. This research will explore the association between increasing copayments, medication and health service utilisation, information critical for informing policy on increasing consumer copayments.Read moreRead less
Hepatitis B Virus Immunity In Indigenous And At Risk Children Who Received Hepatitis B Vaccination In Infancy
Funder
National Health and Medical Research Council
Funding Amount
$213,762.00
Summary
Hepatitis B virus (HBV) is transmitted by blood exposure or sexual contact and infection can result in chronic liver disease and liver cancer. Since 2000 Hepatitis B virus immunisation has been recommended for all infants in Australia with the first dose given at birth. However, prior to routine universal immunisation, a selective immunisation strategy was used in Australia from 1986. This targeted infants considered at high risk of HBV infection because of high prevalence in their population of ....Hepatitis B virus (HBV) is transmitted by blood exposure or sexual contact and infection can result in chronic liver disease and liver cancer. Since 2000 Hepatitis B virus immunisation has been recommended for all infants in Australia with the first dose given at birth. However, prior to routine universal immunisation, a selective immunisation strategy was used in Australia from 1986. This targeted infants considered at high risk of HBV infection because of high prevalence in their population of origin, (including Aboriginal- Torres Strait Islanders) and infants whose mother was a HBV carrier. These children, among the first to be vaccinated, are now adolescents. There have been no long-term follow-up studies in Australia, and limited studies elsewhere, to assess the extent of breakthrough infection and persistence of immunity to Hepatitis B after vaccine at birth. As onset of sexual activity is associated with an increased exposure to hepatitis B infection, booster doses may be needed, especially in high-risk individuals. This study includes 2 high risk groups - young indigenous adults in the Northern Territory and young adults born to HBV carrier mothers in central Sydney. It will measure the number of children who have been infected with HBV or are chronic carriers, compared to pre immunisation data, and also the persisting level of immunity in children who were vaccinated against HBV as an infant. Children whose blood test indicates that they have low immunity will be given a booster dose of HBV vaccine and their immune response measured. A rise in hepatitis B antibody following booster vaccination indicates that you have immunological memory and is currently considered to show protection from natural hepatitis B infection. If clinically significant HBV infections are found to be rare and immunologic memory can be demonstrated, this would provide good evidence to support the argument that booster vaccine doses are not required in the Australian context.Read moreRead less