Publications
123 results found
Damiani G, Federico B, Bianchi CBNA, et al., 2011, Socio-economic status and prevention of cardiovascular disease in Italy: evidence from a national health survey, EUROPEAN JOURNAL OF PUBLIC HEALTH, Vol: 21, Pages: 591-596, ISSN: 1101-1262
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- Citations: 22
Beaglehole R, Bonita R, Horton R, et al., 2011, Priority actions for the non-communicable disease crisis, LANCET, Vol: 377, Pages: 1438-1447, ISSN: 0140-6736
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- Citations: 1146
Sassi F, 2010, Obesity and the economics of prevention: Fit not fat, ISBN: 9781849808606
'This volume, initiated by the OECD, provides an overview of trends and future projections of obesity; discusses the economic costs associated with this major health issue; and examines various government and market strategies designed to prevent this growing problem. . . A timely, valuable volume on a critical issue. Highly recommended. All readership levels.' © OECD 2010. All rights reserved.
Cecchini M, Sassi F, Lauer JA, et al., 2010, Chronic Diseases: Chronic Diseases and Development 3 Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness, LANCET, Vol: 376, Pages: 1775-1784, ISSN: 0140-6736
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- Citations: 555
Lejeune C, Sassi F, Ellis L, et al., 2010, Socio-economic disparities in access to treatment and their impact on colorectal cancer survival, INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, Vol: 39, Pages: 710-717, ISSN: 0300-5771
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- Citations: 77
McDaid D, Sassi F, 2010, Equity, Efficiency and Research Synthesis, Evidence-Based Decisions and Economics: Health Care, Social Welfare, Education and Criminal Justice, Second Edition, Pages: 67-78, ISBN: 9781405191531
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- Citations: 6
Sassi F, 2010, Obesity and the economics of prevention: Fit not fat, ISBN: 9789264063679
Before 1980, rates were generally well below 10%. They have since doubled or tripled in many countries, and in almost half of the OECD, 50% or more of the population is overweight. A key risk factor for numerous chronic diseases, obesity is a major public health concern. This book contributes to evidence-based policy making by exploring multiple dimensions of the obesity problem. It examines the scale and characteristics of the epidemic, the respective roles and influence of market forces and governments, and the impact of interventions. It outlines an economic approach to the prevention of chronic diseases that provides novel insights relative to a more traditional public health approach. The analysis was undertaken by the OECD, partly in collaboration with the World Health Organization. The main chapters are complemented by special contributions from health and obesity experts, including Marc Suhrcke, Tim Lobstein, Donald Kenkel and Francesco Branca. "a valuable set of results and suggestions about the best preventive interventions to reduce the burden of obesity." - Julio Frenk, Dean, Harvard School of Public Health "The positive message of this book is that the obesity epidemic can be successfully addressed." - Ala Alwan, Assistant Director-General, World Health Organization "innovative and well-researched" - Martin McKee, Professor, London School of Hygiene & Tropical Medicine "A timely, valuable volume on a critical issue. Highly recommended."-Choice, July 2011.
Sassi F, 2010, Obesity and the economics of prevention: Fit not fat, ISBN: 9781849808606
The authors, including special contributions from health and obesity experts Marc Suhrcke, Tim Lobstein, Donald Kenkel and Francesco Branca, challenge the perception that explanations for the obesity epidemic are simple and solutions are within reach. A detailed look at the data reveals a more complicated picture, one in which even finding objective evidence on the phenomenon is a difficult task.
Sassi F, 2009, Health inequalities: a persistent problem, TOWARDS A MORE EQUAL SOCIETY?: POVERTY, INEQUALITY AND POLICY SINCE 1997, Editors: Hills, Sefton, Stewart, Publisher: POLICY PRESS, Pages: 135-155
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- Citations: 3
Saissi F, McKee M, 2008, Do clinicians always maximize patient outcomes? A conjoint analysis of preferences for carotid artery testing, JOURNAL OF HEALTH SERVICES RESEARCH & POLICY, Vol: 13, Pages: 61-66, ISSN: 1355-8196
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- Citations: 6
Danishevski K, Mckee M, Sassi F, et al., 2008, The decision to perform Caesarean section in Russia, INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, Vol: 20, Pages: 88-94, ISSN: 1353-4505
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- Citations: 17
Sassi F, Luft HS, Guadagnoli E, 2006, Reducing racial/ethnic disparities in female breast cancer: Screening rates and stage at diagnosis, AMERICAN JOURNAL OF PUBLIC HEALTH, Vol: 96, Pages: 2165-2172, ISSN: 0090-0036
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- Citations: 75
Sassi F, 2006, Calculating QALYs, comparing QALY and DALY calculations, HEALTH POLICY AND PLANNING, Vol: 21, Pages: 402-408, ISSN: 0268-1080
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- Citations: 333
Simpson N, Anderson R, Sassi F, et al., 2005, The cost-effectiveness of neonatal screening for cystic fibrosis: an analysis of alternative scenarios using a decision model, Cost Effectiveness and Resource Allocation, Vol: 3, Pages: 8-8, ISSN: 1478-7547
BACKGROUND: The use of neonatal screening for cystic fibrosis is widely debated in the United Kingdom and elsewhere, but the evidence available to inform policy is limited. This paper explores the cost-effectiveness of adding screening for cystic fibrosis to an existing routine neonatal screening programme for congenital hypothyroidism and phenylketonuria, under alternative scenarios and assumptions. METHODS: The study is based on a decision model comparing screening to no screening in terms of a number of outcome measures, including diagnosis of cystic fibrosis, life-time treatment costs, life years and QALYs gained. The setting is a hypothetical UK health region without an existing neonatal screening programme for cystic fibrosis. RESULTS: Under initial assumptions, neonatal screening (using an immunoreactive trypsin/DNA two stage screening protocol) costs 5,387 pound sterling per infant diagnosed, or 1.83 pound sterling per infant screened (1998 costs). Neonatal screening for cystic fibrosis produces an incremental cost-effectiveness of 6,864 pound sterling per QALY gained, in our base case scenario (an assumed benefit of a 6 month delay in the emergence of symptoms). A difference of 11 months or more in the emergence of symptoms (and mean survival) means neonatal screening is both less costly and produces better outcomes than no screening. CONCLUSION: Neonatal screening is expensive as a method of diagnosis. Neonatal screening may be a cost-effective intervention if the hypothesised delays in the onset of symptoms are confirmed. Implementing both antenatal and neonatal screening would undermine potential economic benefits, since a reduction in the birth incidence of cystic fibrosis would reduce the cost-effectiveness of neonatal screening.
Sassi F, McDaid D, Ricciardi W, 2005, Conjoint analysis of preferences for cardiac risk assessment in primary care, INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE, Vol: 21, Pages: 211-218, ISSN: 0266-4623
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- Citations: 13
Sassi F, 2005, Tackling health inequalities, A More Equal Society?: New Labour, Poverty, Inequality and Exclusion, Pages: 69-92, ISBN: 9781861345776
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- Citations: 8
Sassi F, Carrier J, Weinberg J, 2004, Affirmative action: the lessons for health care - Governments are becoming more assertive about reducing ethnic inequalities, BMJ-BRITISH MEDICAL JOURNAL, Vol: 328, Pages: 1213-1214, ISSN: 1756-1833
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- Citations: 5
Sassi F, 2003, Setting priorities for the evaluation of health interventions: when theory does not meet practice., Health Policy, Vol: 63, Pages: 141-154, ISSN: 0168-8510
Priority setting is a key component of the process of evaluating health interventions. This has traditionally been an informal process led by power and influence, but a number of explicit criteria and systematic models have been developed since the late 1980s. This paper presents a review and appraisal of these conceptual models and examines how they have influenced the practice of priority setting in the United States and Europe. The main conclusion is that a significant gap exists between theory and practice. Most models have been developed for the purpose of maximising health gains through an efficient allocation of resources. However, they present at least three important limitations that need to be removed if formal models are to play a more substantial role in decision making: they tend to prioritize interventions for evaluation, rather than evaluations themselves; they fail to address priority setting in a research portfolio perspective; and they fail to adopt an incremental perspective. Existing prioritization models are not suitable for supporting cost-containment or distributional objectives.
McDaid D, Cookson R, Maynard A, et al., 2003, Evaluating health interventions in the 21st century: old and new challenges, HEALTH POLICY, Vol: 63, Pages: 117-120, ISSN: 0168-8510
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- Citations: 8
Cunningham SJ, Sculpher M, Sassi F, et al., 2003, A cost-utility analysis of patients undergoing orthognathic treatment for the management of dentofacial disharmony., Br J Oral Maxillofac Surg, Vol: 41, Pages: 32-35, ISSN: 0266-4356
INTRODUCTION: Management of dentofacial discrepancies using orthognathic treatment is now a common procedure in the United Kingdom. Although the benefits of orthognathic intervention are often considered, the cost implications have not been investigated to our knowledge. This study is a cost-utility analysis of orthognathic treatment. PATIENTS AND METHODS: Twenty-one patients were interviewed five times during treatment using the time trade-off (TTO) method to establish utility values. Quality adjusted life years (QALYs) gained as a result of treatment were calculated and discounted. The resource use was calculated for each of the 21 patients individually and the costs subjected to both a sensitivity analysis and discounting. The incremental mean cost per additional QALY was calculated (as compared with a 'no treatment' approach). RESULTS: The incremental cost for each additional QALY was 561 pounds sterling for the groups combined, based on mean additional costs and QALYs (546 pounds sterling for the bimaxillary group and 617 pounds sterling for the single jaw group). DISCUSSION: Orthognathic treatment seems to provide good outcomes at relatively low cost. Even allowing for the uncertainty in mean costs and QALYs, there is a high probability of treatment being cost-effective. Cost-utility analysis is still a relatively new technique in dentistry and further studies should be encouraged.
Wimo A, von Strauss E, Nordberg G, et al., 2002, Time spent on informal and formal care giving for persons with dementia in Sweden., Health Policy, Vol: 61, Pages: 255-268, ISSN: 0168-8510
The purpose of this paper was to explore the time spent on caring by families of persons with dementia in Sweden. As part of a European Commission project, interviews were carried out on a sample of 92 carers, caring for persons with dementia. The interviews focused on time spent on caring, IADL, ADL and surveillance, as well as formal support received and used. Informal care, measured as hours spent caring, was about 8.5 times greater than formal services (299 and 35 h per month, respectively). Approximately 50% of the total informal care consisted of time spent on surveillance (day and night). Formal care input and informal support, in terms of ADL increased with dementia severity. A regression analysis showed that dementia severity, behavioural disturbances and coping were associated with the amount of informal care. This study gives some new perspectives on informal care giving for persons with dementia and support strategies in general. Some carers do carry a very heavy 24 h responsibility. This aspect of caring must be addressed by the development of well-targeted respite and relief support programmes.
Sassi F, Archard L, McDaid D, 2002, Searching literature databases for health care economic evaluations - How systematic can we afford to be?, MEDICAL CARE, Vol: 40, Pages: 387-394, ISSN: 0025-7079
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- Citations: 55
Sassi F, Le Grand J, Archard L, 2001, Equity versus efficiency: a dilemma for the NHS - If the NHS is serious about equity it must offer guidance when principles conflict, BRITISH MEDICAL JOURNAL, Vol: 323, Pages: 762-763, ISSN: 0959-535X
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- Citations: 34
Sassi F, Archard L, Le Grand J, 2001, Equity and the economic evaluation of healthcare., Health Technol Assess, Vol: 5, Pages: 1-138, ISSN: 1366-5278
Lattimer V, Sassi F, George S, et al., 2000, Cost analysis of nurse telephone consultation in out of hours primary care: evidence from a randomised controlled trial., BMJ, Vol: 320, Pages: 1053-1057, ISSN: 0959-8138
OBJECTIVE: To undertake an economic evaluation of nurse telephone consultation using decision support software in comparison with usual general practice care provided by a general practice cooperative. DESIGN: Cost analysis from an NHS perspective using stochastic data from a randomised controlled trial. SETTING: General practice cooperative with 55 general practitioners serving 97 000 registered patients in Wiltshire, England. SUBJECTS: All patients contacting the service, or about whom the service was contacted during the trial year (January 1997 to January 1998). MAIN OUTCOME MEASURES: Costs and savings to the NHS during the trial year. RESULTS: The cost of providing nurse telephone consultation was 81 237 pound sterling per annum. This, however, determined a 94 422 pound sterling reduction of other costs for the NHS arising from reduced emergency admissions to hospital. Using point estimates for savings, the cost analysis, combined with the analysis of outcomes, showed a dominance situation for the intervention over general practice cooperative care alone. If a larger improvement in outcomes is assumed (upper 95% confidence limit) NHS savings increase to 123 824 pound sterling per annum. Savings of only 3728 pound sterling would, however, arise in a scenario where lower 95% confidence limits for outcome differences were observed. To break even, the intervention would have needed to save 138 emergency hospital admissions per year, around 90% of the effect achieved in the trial. Additional savings of 16 928 pound sterling for general practice arose from reduced travel to visit patients at home and fewer surgery appointments within three days of a call. CONCLUSIONS: Nurse telephone consultation in out of hours primary care may reduce NHS costs in the long term by reducing demand for emergency admission to hospital. General practitioners currently bear most of the cost of nurse telephone consultation and benefit least from the savings associated with it. This indica
Sassi F, 2000, [Vaccination against S. pneumoniae: effective and efficient approach?]., Ann Ig, Vol: 12, Pages: 85-97, ISSN: 1120-9135
Sassi F, 2000, The European way to health technology assessment. Lessons from an evaluation of EUR-ASSESS., Int J Technol Assess Health Care, Vol: 16, Pages: 282-290, ISSN: 0266-4623
OBJECTIVES: The EUR-ASSESS project was undertaken by a large number of members of European health technology assessment (HTA) agencies and programs with the aim of improving coordination through developments in several areas of HTA. At the conclusion of the project, an independent survey was undertaken to reassess the importance of the original objectives of EUR-ASSESS and determine the impact of the project on the way HTA activities are organized and carried out in Europe. METHODS: A postal questionnaire survey and a series of more in-depth personal interviews. RESULTS: EUR-ASSESS was generally considered successful in achieving its aims, particularly in creating an informal network of people and organizations, improving the understanding of the work of others, improving the ability to focus the objectives of HTA, facilitating the sharing of experience and mutual learning opportunities, exchanging ideas on research agendas, and developing a common language. However, significant differences emerged in the expectations of different actors in European HTA, and in their perceptions of the impact of the project. These reflect the wide diversity of approaches existing in Europe. CONCLUSIONS: Health technology assessment in Europe is changing its nature from a set of national or local initiatives with relatively limited impact to a truly European movement with strong links and coordination between its individual components. Important lessons can be learned from the experience of EUR-ASSESS, particularly in the light of an increasing commitment of the European Commission to play a role in the development of technology assessment.
Sassi F, 1998, The economic impact of inflammatory bowel disease, Pages: 191-195, ISSN: 0143-3083
Inflammatory bowel disease (IBD) generates important economic issues in industrialised countries, despite the relatively low number of people affected by the condition. Information on the epidemiological features of IBD, its natural history, and the outcomes of medical interventions is still limited. This makes economic evaluations more difficult in this therapeutic area. This paper will address two main questions: to what extent does IBD have a significant economic impact and why and how economic aspects should be taken into account in research and clinical practice. The burden of disease is assessed by economists with reference to mortality and morbidity associated with the disease. These generate costs in terms of direct medical expenses for managing the disease, expenses paid out of pocket by patients, working time and productivity losses. These costs have been estimated for IBD in two countries: USA and Italy. Comparison of data provided by studies carried out in different countries are extremely difficult. However, the evidence available seems to suggest a striking similarity between the costs of treating IBD in the USA and Italy, although ulcerative colitis patients seem to be more expensive in Italy, and Crohn's disease patients more expensive in the USA. Inflammatory bowel disease is particularly important from an economic viewpoint because grounds of the outcomes they produce. Moreover, patients can be managed in many different ways, with equally different cost implications, and evidence of the cost-effectiveness of alternative practices is yet to be assessed. Studies of clinical practice variations have a fundamental role in the search for a better understanding of the economic consequences of IBD and its treatment.
Sassi F, 1998, [The new general medicine in the new NHS white paper]., Ann Ig, Vol: 10, Pages: 395-403, ISSN: 1120-9135
Sassi F, McKee M, Roberts JA, 1997, Economic evaluation of diagnostic technology. Methodological challenges and viable solutions., Int J Technol Assess Health Care, Vol: 13, Pages: 613-630, ISSN: 0266-4623
The principles of economic evaluation are increasingly accepted by clinicians and policy makers as evidence from a significant number of studies becomes available to support their decisions. However, methods of assessment still need to be improved. This paper reports a comprehensive review of methodological challenges in the economic evaluation of diagnostic technology, where such challenges are more evident. This review formed the basis for a prioritized research agenda, with four main areas: modeling techniques for dealing with complexity; measures of the opportunity cost of shared resources; techniques for eliciting decision makers' utility functions for diagnostic tests; and ways of assessing the robustness of decisions. A number of methodological solutions are proposed, aimed at capturing elements and relationships that are usually neglected and fully recognizing the presence of an inductive cognitive component in decision-making processes.
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