Harkness Project Title: Coverage Policy in the U.S. and the U.K.: An Investigation of Principles, Processes and the Use of Cost-Effectiveness Information
Mentor: Alan Garber, M.D., Ph.D.
Placement: Center for Primary Care and Outcomes Research, Stanford University
Biography at time of Harkness Fellowship: Stirling Bryan, Ph.D., a 2005-06 Commonwealth Fund Harkness Fellow in Health Care Policy, is director of the Health Economics Facility and professor of health economics at the University of Birmingham, U.K. His principal research interest is in the challenge posed by new medical technologies, and policy approaches to deal effectively with such challenges. His work in the U.S. has explored these issues at Kaiser-Permanente, Aetna, Blue Cross Blue Shield, and the Veterans Health Administration. More broadly his research has covered the areas of economic evaluation and health technology assessment from applied and methodological perspectives, including preference elicitation and outcome measurement, and the use of economic analyses in decision-making. He has published extensively in these areas. Bryan is a member of the U.K. Medical Research Council’s College of Experts and the Standing Scientific Committee of the International Health Economics Association (iHEA). Formerly he sat on the Appraisal Committee of the U.K. National Institute for Health & Clinical Excellence. Bryan holds a doctorate in economics from Brunel University.
Project: Bryan’s research sought to describe technology coverage policy in a number of U.S. health care organizations, and to elicit stakeholders’ views on coverage policy and, specifically, on the use of cost-effectiveness information. He undertook a literature review and case studies at four U.S. organizations that make coverage decisions (Kaiser Permanente, Aetna, Blue Cross Blue Shield, and the Veterans Health Administration), including interviews, document analysis, and workshops with senior decision-makers.
Career Activity Since Fellowship
- Director, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, 2010
- Associate, Centre for Health Services & Policy Research, University of British Columbia, 2009
- Professor, Department of Medicine, University of British Columbia, 2008
- Associate Director, Centre for Clinical Epidemiology and Evaluation, University of British Columbia, 2008
- Head, Department of Health Economics, University of Birmingham, 2007
- Adjunct Associate, Center for Health Policy, Stanford University, 2006
- Reappointment to NICE Appraisal Committee, 2006
Current Position: Director, Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Canada. (Updated August 2010)
Arrow K, Auerbach A, Bertko J, et al. “Toward a 21st-century health care system: recommendations for health care reform.” Ann Intern Med. 2009 Apr 7;150(7):493-5
Bryan S, Sofaer S, Siegelberg T, Gold M. "Has the time come for cost-effectiveness in U.S. health care?" Health Economics, Policy and Law 2009 Oct;4(Pt 4):425-43
Williams I, McIver S, Moore D, Bryan S. “The Use of Economic Evaluation in NHS Decision-Making: A Review and Empirical Investigation.” Health Technology Assessment 2008;12(7)
Bryan S. “Editorial: Darzi on NICE: The Case for Clinician Management in HTA.” Health Economics, 2008; 17: 1321-1327.
Bryan S, Williams I, McIver S. “Seeing the NICE Side of Cost-Effectiveness Analysis: A Qualitative Investigation of the Use of Cost-Effectiveness Analysis in NICE Technology Appraisals,” Health Economics 2007;16(2):179-193
Williams I, Bryan S, McIver S. “How Should Cost-effectiveness Analysis be Used in Health Technology Coverage Decisions? Evidence from the NICE approach,” Journal of Health Services Research & Policy 2007;12(2):73-79
Gold M, Bryan S. “Some Reasons to be Cheerful About NICE,” Health Economics, Policy and Law 2007; 2(2):209-216
Williams I, Bryan S. “Understanding the Limited Impact of Economic Evaluation in Health Care Resource Allocation: a conceptual framework,” Health Policy 2007; 80:135-143.