As part of my PhD, I spent two months at the Center for the Evaluation of Value and Risk in Health (CEVR) at the Tufts Medical Center in Boston, USA. My PhD research at the London School of Hygiene & Tropical Medicine involves analysing how uncertainty in the clinical and economic evidence is considered in the health technology assessment (HTA) processes for medicines in England and Germany. Put simply, most HTA agencies decide whether medicines should be reimbursed within publicly funded healthcare systems, or play an important role in informing pricing negotiations. My research focuses specifically on drugs for rare diseases, which are usually very costly, and for which there is often only limited clinical and economic evidence available. This is due to small patient populations, short trial durations, a lack of alternative active treatments, and uncertainty surrounding standards of care and patient outcome measurement. These issues typically increase the uncertainty about a medicine’s benefits when HTA agencies make reimbursement decisions.
Visiting CEVR enabled me to collaborate with health economists and HTA researchers who analyse these issues from a US perspective. Given differences between the US and European healthcare systems, I was able to engage with the debate on how the value of a new drug should be assessed from a different perspective. During my visit, I also had the opportunity to contribute to ongoing research projects and to attend departmental seminars. I also met with CEVR faculty and staff members to learn about their research and policy trends in American academia. Outside of my work at CEVR, I was able to connect with other PhD students, early career researchers, and academics working at different universities in the Boston area, including Harvard and the MIT. The city is a vibrant academic hub, and exposure to an academic system outside of the UK was fascinating.
Overall, the international institutional visit to CEVR was invaluable, both for my personal and academic development. Meeting and working with academics researching HTA, health policy and health economics topics at CEVR was very rewarding. It helped me to expand my network and provided me with insights into a different academic and healthcare system. I would highly recommend an international institutional visit to any PhD student, as it enhances critical thinking, broadens your perspective, and offers opportunities to contribute to additional research projects. I am grateful to UBEL for their generous financial support, and to CEVR for making this international institutional visit possible.
Lea Wiedmann (she/her)
PhD Student in Health Economics and Policy
Department of Health Services Research and Policy
London School of Hygiene and Tropical Medicine