How should health systems balance efficiency with fairness?

The growing emphasis on health equity within health technology assessment (HTA) is reshaping how decisions are made globally. Methods such as distributional cost-effectiveness analysis (DCEA) are at the forefront of this change, helping policymakers move beyond average outcomes to understand who benefits, and who may be left behind.

Director of Digital Health Consulting, Hayden Holmes, and Project Directors, Rob Malcolm and Angel Varghese, offer their insights into the topic in a roundtable blog. They explore:

• What we mean by health equity in economic evaluation.
• How DCEA can quantify trade-offs between maximising population health and reducing inequalities.
• The practical and methodological challenges of applying these approaches.
• Why international momentum, from guideline development to HTA practice, signals a clear direction of travel.

Read the blog.

From discussion to action: what’s next for sustainable healthcare?

Senior Research Consultant, Melissa Pegg, joined global colleagues at the DIA Europe Conference in Rotterdam to move forward the conversation on environmental sustainability in a key session on HTA and the medicines lifecycle.

Melissa shared insights from the from her role as chair of the HTAi Environmental Sustainability in HTA Working Group at a panel session titled 'Sustainability, Access, and Value: Building Environmental Considerations into the Evaluation of Health Interventions'.

She said: "Alongside DIA colleagues who are calling for holistic yet pragmatic action, the conference spotlighted the urgent need to move beyond discussion and into action. By piloting practical approaches and methods now, we can drive the measurable, system-wide progress needed for more sustainable healthcare innovation and delivery."

Contact us to find out more about integrating environmental sustainability into your HTA strategy.

Shifting the focus to real-world impact

YHEC Project Director, Andria Joseph (right), joined an expert panel at the European Congress of Radiology (ECR 2026) to discuss the future of value-based radiology.

Andria highlighted a critical industry shift: moving beyond image quality and diagnostic accuracy towards real-world impact. Her message was clear: radiology and imaging AI must demonstrate how they improve clinical decisions, patient outcomes, affordability and equity, rather than just increasing activity or throughput.

Alongside wider discussions on multidisciplinary care and sustainability, the session reinforced that true value in radiology must be proven across the entire patient pathway.

To find out more about Andria’s work in value-based healthcare, contact us.

A seat at the table: a perspective on membership of a NICE committee

Stuart Mealing, YHEC Director of Pharmaceutical Consulting, shares his experience as a member of NICE’s Highly Specialised Technologies Evaluation Committee (HSTEC) in a blog.

He discusses:

• Why ultra-orphan conditions present unique challenges for HTA.
• How the HST process differs from conventional NICE appraisals.
• Why clinical and patient testimony plays such an important role.
• How committee work is evolving to better reflect the needs of the rare disease community.

Stuart also offers a personal reflection on what it is like to sit at the table where some of the NHS’s most complex and high-stakes decisions are made.

For anyone working in rare diseases, HTA, market access or evidence generation, this is a valuable commentary on the realities of decision-making in one of the most challenging areas of assessment.

Read more.  

YHEC's Nick Hex offers insights at parliamentary reception

YHEC’s Director of NHS Consulting, Nick Hex, was  recently a guest speaker at a parliamentary event on The Future of Sepsis Care.

The event was hosted by sepsis-survivor, Lord Mackinlay of Richborough, and brought together clinicians, policymakers, parliamentarians and individuals with lived experience to explore how lasting, system-wide improvements in sepsis care can be achieved.

The discussion comes at a pivotal moment, with the development of a Modern Service Framework (MSF) for sepsis. As MSFs form a central component of the National Health Service 10-year strategy for service transformation, there is growing momentum to ensure that sepsis is prioritised within this approach.

Is it time to move beyond the “minimally important change”?

The idea that a single threshold can define meaningful improvement in patient-reported outcome measures (PROMs) is increasingly being challenged.

In a YHEC blog, we draw on our recent publication, analysing 380,000+ NHS records to show that for the Oxford Hip and Knee Scores, what counts as “important” change depends strongly on where patients start. A one-size-fits-all minimally important change risks oversimplifying patient outcomes.

Our work contributes to a growing debate calling for a more nuanced, context-sensitive interpretation of PROMs.

Read more. 

Sustainability is becoming a key part of the conversation in Saudi healthcare

YHEC’s Melissa Pegg attended the 4th Formulary Management Conference in Saudi Arabia to support discussions around developing environmental sustainability in HTA.

Reflecting on the event, Melissa said:

"A recurring theme throughout the week was the need for formulary decisions to support more sustainable health technology. To do that effectively, we should look at embedding environmental domains alongside traditional clinical and economic domains to help shape the future of innovative and sustainable health technology use in Saudi Arabia."

As HTA evolves to consider carbon impacts and planetary health, there is a significant opportunity to collaborate on frameworks like the Saudi Environmental Formulary Assessment Tool (SEFAT) to embed sustainability in decision making. The discussions in Riyadh suggest a clear path forward: advancing sustainable HTA will rely on practical tools, bold collaboration and the recognition that inaction is no longer an option.

Contact us to find out more about Melissa's work.

NICE-MHRA aligned pathway launch

The NICE-MHRA aligned pathway launched on 01 April, marking an important development for medicines access in England. Designed to better align regulatory approval and health technology assessment, the new pathway aims to reduce delays between licensing and NICE guidance, helping patients access new medicines sooner.

In the new pathway, NICE aims to publish guidance at the same time as MHRA marketing authorisation, rather than following it by up to 90 days. NICE appraisal committee meetings may now take place in public before marketing authorisation is granted, with draft recommendations published earlier where appropriate.

A new integrated scientific advice service will support companies in developing evidence plans that meet both regulatory and HTA requirements.

If you would like to discuss what this could mean for your product, portfolio, or evidence strategy, contact us.

40 Years of YHEC: the people who shaped the company 

To mark YHEC’s 40th anniversary, we are sharing a series of alumni blogs reflecting on careers, experiences, and the impact of time spent at YHEC.

In these three blogs, Adam Gordois, John Posnett and Andy Street share memories from the early years of YHEC, when the organisation was transitioning into a health economics consultancy.

They reflect on the career paths that followed, working with global medical technology companies, clinical research organisations and beyond.

Read more.

BMC Gastroenterology

The latest paper in a growing series of research on RefluxStop, co-authored by YHEC’s Sam Harper and Stuart Mealing, has been published in BMC Gastroenterology. 

This new study evaluates the cost-effectiveness of RefluxStop in Italy for the treatment of gastroesophageal reflux disease (GERD), comparing it with current medical and surgical standards of care, including proton pump inhibitors, laparoscopic Nissen fundoplication, and magnetic sphincter augmentation. Using a lifetime Markov model from the Italian healthcare payer perspective, the analysis found that RefluxStop is highly likely to be cost-effective, with favourable incremental cost-effectiveness ratios across all comparators and strong results in sensitivity analyses.

Read the full paper.

Injury journal

A new paper, co-authored by YHEC’s Sam Harper and Ciara Buckley, has been published in the Injury journal.

The study models the cost-effectiveness of continuous pressure monitoring (CPM) for patients at risk of acute compartment syndrome following tibial diaphyseal fracture. From a UK NHS perspective, the analysis suggests CPM could deliver savings of £452 per patient, reduce hospital stay by 2,733 bed days per 1,000 patients, and improve quality-adjusted life year outcomes compared with standard diagnostic approaches.
These findings provide early evidence that CPM may be a valuable and cost-effective diagnostic adjunct in this setting.

Read more.

Journal of Dermatological Treatment

Are people with mild-to-moderate psoriasis being underserved by current treatment pathways?

New research using UK real-world data highlights a substantial clinical and economic burden in this population, despite ongoing systemic treatment. YHEC’s Joe Moss, Erin Barker and Neil Hansell are co-authors of the paper, published in the Journal of Dermatological Treatment.

Read the study via our website. 

Journal of Allergy and Clinical Immunology: Global

Understanding the clinical evidence for immunoglobulin replacement therapy (IgRT) in primary immunodeficiency disorders (PIDDs) remains challenging. A recent pragmatic review and evidence mapping study, co-authored by YHEC’s Emma Carr, Rachael McCool, Mick Arber and Katie Reddish, synthesises over 100 studies in this area.

The findings suggest limited evidence of differences in outcomes between IgRT brands. However, substantial heterogeneity in study design and reporting limits the feasibility of robust comparative analyses, including indirect treatment comparisons. The study highlights a clear priority for future research: improving consistency in the reporting of patient characteristics, outcomes, and follow-up to enable more reliable comparisons and better support decision-making.

Read more.

Journal of Medical Economics

Smoking cessation services are typically evaluated in terms of their effectiveness and cost-effectiveness; however, an important additional consideration is whether they can also contribute to reducing health inequalities. A study co-authored by YHEC’s Harriet Fewster, Robert Malcolm and Hayden Holmes explores this through a distributional cost-effectiveness analysis (DCEA) of integrating smoking cessation support into the English Lung Cancer Screening (LCS) programme.

The analysis indicates that the intervention is cost-effective and dominates usual care, delivering substantial net health benefit. Notably, these benefits are not evenly distributed across the population, with the greatest gains observed among the most socioeconomically deprived groups.

The full paper is available via our website.

Health Services and Outcomes Research Methodology

Comparing in vitro diagnostics (IVDs) with imaging tests in HTA is methodologically complex and often oversimplified. A new paper in Health Services and Outcomes Research Methodology identifies the key challenges and provides practical recommendations to support more robust health economic modelling of diagnostic technologies.

YHEC's Karina Watts, Emily Gregg, Deborah Watkins, Stuart Mealing and Hayden Holmes are co-authors of the research. Drawing on a multi-methods approach, including an evidence review, expert workshops and stakeholder interviews, the work highlights critical issues such as diagnostic pathway complexity, evidence gaps, incidental findings and capacity constraints.

Read more. 

New vacancies: Research Consultants

York Health Economics Consortium is recruiting Research Consultants to join our team following completion of a postgraduate degree in health economics, mathematics, operational research, economics, statistics or a related quantitative discipline.

What you’ll do:

• Develop and critique economic models across a diverse project portfolio.
• Evaluate submissions to HTA bodies and assess methodological approaches.
• Analyse complex datasets (including patient-level and survival data).
• Contribute to evidence synthesis, modelling, and client-facing deliverables.
• Engage with stakeholders across industry and the NHS.

This is an opportunity to build strong technical expertise in economic evaluation while working at the interface of research and decision-making.

Closing date: 24 May 2026
Start date: October 2026

Find out more.

It's great to work at YHEC!

YHEC offers a working environment that values collaboration, professional support and the meaningful contribution of its staff. Individuals are encouraged to develop their expertise within a culture that supports both collective achievement and personal progression.

This commitment is reflected in YHEC’s long-standing recognition by Investors in People. The organisation has held this accreditation for more than 25 years, demonstrating sustained excellence in leadership, employee development, and high-performance people management. YHEC currently holds Gold status, with a recent assessment score of 765, well above the industry benchmark of 730, placing it within the top 30% of accredited organisations.

Read our series of Meet the Team blogs and find out more about working at YHEC.