PhD Scholarship Top-up student profile: Philip Haywood

TCRN PhD Scholarship Top-up Recipient: Philip Haywood TCRN PhD Scholarship Top-up Recipient: Philip Haywood

Towards a consistent and validated modelling approach in cancer pharmaceuticals for equity and effectiveness at a local level.

Award: Philip is the recipient of a 3-year PhD Scholarship Top-up

Supervisors:  Prof. Marion Haas, Professor of Health Economics and a Deputy Director of CHERE, UTS & Prof. Rosalie Viney, Director, Centre for Health Economics Research & Evaluation, UTS.

There is a lack of timely economic information at the local level for the treatment of patients with cancer.  My research aims to address these knowledge gaps.  In order to obtain local level information, available data collections will be used to extrapolate from trials (usually based on younger and fitter patients) to a more realistic patient profile.  In Australia, chemotherapy is given as a series of different treatments.  Currently these are assessed one at a time.  In order to improve the timeliness of information, a model will be built to allow the implications of new cancer pharmaceuticals to be assessed.

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What is the translational application of your research?

My research will feed into improvements in clinical and treatment outcomes by improving the information available to decision makers.

First, improved local level information will allow decision makers (including clinicians) to make more informed decisions about the current use of cancer pharmaceuticals and the resulting opportunity costs.

Secondly, the modelling approach undertaken in my research will enable the more timely assessment of costs and outcomes flowing from the introduction of new pharmaceuticals.  This will increase in relevance with the expected increase in treatment options.  This may allow newer pharmaceuticals to be positioned in the treatment continuum for optimal impact, as soon as possible.

This information could improve patients’ outcomes through a number of different mechanisms with resultant behaviour change.

This may allow current treatment decisions to be undertaken with more confidence.  Alternatively it may lead to improved outcomes resulting from a change in the use of pharmaceuticals via a better appreciation of the opportunity cost of the current treatment regime.  It is likely that the benefits of this approach will be maximised by considering the full sequence of cancer treatments rather than a single choice between pharmaceuticals at one point in the treatment continuum.

One aspect of cancer care that is particularly concerning is the variation in care that has been documented for the treatment of cancer. It is unlikely that this research will result in an elimination of variation of care. It may illuminate, however, why such variations exist and allow consideration of potential remedies for the variation in care at the local level.  A reduction in variation of care or outcomes is one way in which inequity may be reduced.

This work will also form the basis for a well-informed debate about the funding of newer pharmaceuticals from agencies other than the Pharmaceutical Benefits Scheme by more realistically tracing out the implications than current methods allow.  This may result in improved access for some patient groups.

The resultant improvement in decision making will aid the maximisation of clinical benefit to the group of patients who attend a cancer centre by maximising the clinical outcome from the available resources.

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“The TCRN will benefit the research quality of my PhD.  Given my approach of developing real world information at a local level, the TCRN represents an important asset.  At this early stage, I have identified two concrete benefits of being involved with TCRN.

First, there are a large number of assumptions of the interdependence of treatments and adverse events involved in the modelling of chemotherapy sequences in the continuum of cancer treatment.  Some of these interdependences have been discussed and quantified in the literature but most have not.  TCRN represents a substantial knowledge base of the potential interdependences that may exist or are assumed to exist.

Secondly, sequences of chemotherapy treatment through the continuum are not well defined.  This has been a well-recognised problem in the international literature.  Although the databases that will be accessed for the PhD will provide an example of sequences, they will necessarily be retrospective.  The TCRN provides an opportunity to consider more contemporary examples of sequences for consideration in the PhD.

During the duration of my PhD, I anticipate there will be other benefits that will flow from collaboration with other cancer professionals.”

Philip Haywood commenced his first year of PhD studies at the Centre for Health Economics Research and Evaluation (“CHERE”), Department of Economics, UTS in 2013.