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LSHTM researchers have developed four computer models to help decision-makers make evidence-based choices about new vaccines and vaccine schedules. These models analyse the public health impact and cost-effectiveness of different options under different assumptions and scenarios on a country-by-country basis. They are used by national immunisation managers and key decision-makers, international committees and partner organisations (e.g. the Global Alliance for Vaccines and Immunisation and the Bill & Melinda Gates Foundation). LSHTM's researchers have built on this research for WHO, informing global recommendations on vaccine timing and schedules.
University of Sheffield research which evaluated the clinical and cost-effectiveness of statins for the primary and secondary prevention of cardiovascular events has directly led to an additional 3.3 million people in England and Wales becoming eligible for this treatment. Statins have been shown to reduce the risk of future cardiovascular events, such as heart attacks and stroke.
Guidance on statin prescribing in England and Wales, issued by the National Institute for Health and Care Excellence (NICE) Appraisal Committee in January 2006 was informed by our research report. Following this guidance the number of patients receiving statins has increased year on year with the number of prescriptions increasing by 29% between 2007 and 2011, enabling these patients to benefit from reduced risk of heart attacks and stroke and CVD related deaths.
Globally, many health research-funding organisations, public and charitable, felt the need to demonstrate to policymakers and the public how their investments in research were benefitting society. HERG's research on developing techniques for assessing the payback (or impact) from health research tackled this need. The payback stream of research itself has had significant, wide- reaching and cumulative impacts. First, internationally, health research funding bodies adopted the framework in their evaluation strategies, including to provide accountability. Second, many stakeholders made extensive use the findings of payback studies in public debate and private lobbying for public expenditure on health research. Third, governments, public research funding bodies and medical research charities, from the UK to Australia, used the findings from payback studies to inform decisions regarding the levels and distribution of health research funding, with the aim of increasing the health and economic benefits that come from investments in research.
The NHS spends about £11bn annually on pharmaceuticals, of which £8bn is on branded drugs, representing about 13% and 10% respectively of available NHS resources. Research at York has been central to the public and policy debate about how branded pharmaceuticals ought to be priced and has made a material contribution to the development of government policy to introduce a value based pricing (VBP) scheme for all new pharmaceuticals. VBP has significance for the prices that the NHS pays for pharmaceuticals, access to new drugs for NHS patients, and the return that manufacturers can expect from future research and development. There is also an international impact in two respects: UK prices are estimated to influence 25% of the world market and York has contributed to a wider policy debate about international pharmaceutical pricing and the potential role of value based pricing in European, North American, South American and South East Asian health care systems.
Research at York has had a direct impact on national guidance about the use of health technologies in the NHS. It provided methods that are used to assess whether a technology is expected to be a cost-effective use of NHS resources, how uncertain this assessment is likely to be and whether additional evidence is sufficiently valuable to recommend further research to support its widespread use. It has had an impact on the technologies available in the NHS and the evidence available to support their use: improving patient outcomes; saving NHS resources and strengthening the evidence base for clinical practice. It gives an explicit signal and incentive to manufacturers; informing development decisions and the type of evidence collected. It has had an international impact on how the adequacy of evidence is judged and research is prioritised; particularly in recent reforms in the United States (US) where the principles of this value of information (VOI) analysis are informing the prioritisation of $3.8bn for `comparative effectiveness research'. It has also informed the methods used in low and middle income countries, especially national agencies in health care systems in South East Asia and South America, as well as global funding bodies.
Research undertaken at UCL's Centre for Infectious Disease Epidemiology has provided evidence about vaccination of different groups against influenza which have influenced policy and practice. In particular, our work underpins the government's ongoing policy on vaccination of healthcare workers, and is cited every year in the Chief Medical Officer's letter to healthcare workers as well as international recommendations on influenza vaccination of healthcare workers, including widespread mandatory vaccination programmes in North America. Research on influenza and acute cardiovascular events has informed US recommendations for prevention of stroke through vaccination. Recent work also informed the decision in the UK to extend regular influenza vaccination to children.
A discovery that a tomato extract could help with healthy blood flow has been translated into a functional food ingredient now marketed globally via the spin-out company Provexis plc. Fruitflow® — Provexis' lead product — is the result of findings by researchers at the Rowett Institute of Nutrition and Health, now part of the University of Aberdeen, that biologically active constituents in tomatoes inhibit blood platelet aggregation: a known cause of heart attack, stroke and venous thrombosis. In 2009 Fruitflow® was the first food ingredient to meet the requirements of the European Food Safety Agency for products with a specific health claim. Provexis — the University of Aberdeen Rowett Institute spinout — is listed on the AIM market — the London Stock Exchange's international market for smaller growing companies — has seen values of £14 - £60 million and secured co-development agreements with major international partners, including DSM, Unilever and Coca-Cola. This case study demonstrates the direct translation of research to produce a functional food ingredient of interest to global market players.
The claimed impact therefore relates to development of new product, which has received the first ever novel health claim (Article 13.5) from the European Food Safety Authority, and is being marketed as novel food ingredient globally by a multinational company.
Rabies is the most lethal known infectious disease and kills 55,000 people annually worldwide, mainly in Africa and Asia; however, it is almost entirely preventable. Effective vaccines for animals and humans are available, but their use is limited by cost and accessibility. Research undertaken at the University of Glasgow by Professor Sarah Cleaveland and her team has led to the development and adoption of new health and veterinary policies in East Africa, transforming research findings into practical strategies for rabies prevention and control. These strategies reduce the cost of medical treatment (such as post-exposure prophylaxis), increase its effectiveness (by improving compliance) and eliminate the barriers to receiving treatment in some of the world's most disadvantaged communities. Research by the Glasgow team on dog vaccination strategies has also made a major contribution to the recognition by the World Health Organization (WHO) that global canine rabies elimination is feasible, with national and global strategies now focussing on dog vaccination as a cost effective means of reducing human rabies deaths.
Research by the Community and Health Research Unit (CaHRU) has had broad international and national impact on community-based prevention, influencing influenza and pneumococcal vaccination policy and practice in the UK, North America and Australia, and impacting on general practitioner and primary healthcare. This has led to improvements in influenza vaccination in the elderly aged 65 years and over as well as younger people aged two years and over at risk of influenza and pneumonia, in Lincolnshire, UK and internationally via policy, education and guidance since 1999.
The research has increased public and practitioner awareness of the link between influenza and cardiovascular disease and the potential for influenza vaccination to prevent acute myocardial infarction (AMI) and stroke. It has affected international vaccination policy; through the findings being incorporated into national guidance for general practices and e-learning on how to improve UK influenza vaccination rates. Overall there has been a substantial take-up of our findings and recommendations.
Pioneering interdisciplinary research at the Royal Veterinary College (RVC) has enabled governments internationally and global health authorities to respond swiftly to the outbreak of a disease that causes huge economic losses, threatens the livelihoods of vulnerable populations in the developing world and endangers human lives. Supported by proactive dissemination, it has shaped the control policies and risk management strategies of the United Nations and governments across Asia, Africa and Europe, as well as a national contingency plan for the UK. And it has demonstrated that costly vaccination campaigns and mass culling programmes can be avoided in efforts to bring the disease under control.