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This week, the Health Economics Research Centre (HERC) at Oxford Population Health is celebrating its 25th anniversary. From small beginnings, the unit has developed into a world-renowned centre of excellence in quantifying the true value of disease interventions, and developing strategies to optimise limited healthcare resources.

HERC’s objective is to apply rigorous and innovative research methods to examine the economic aspects of health and disease; the costs and benefits of prevention and treatment; and the design and evaluation of health systems. The unit began as a one-man team: Professor Alastair Gray, who later became HERC’s first Director. ‘I was working for the Open University in Oxford, and was approached by various researchers from Oxford University’s Department for Public Health (the fore-runner to Oxford Population Health) who needed health economics input for their projects, for instance, a major review on Hormone Replacement Therapy commissioned by the Government. It became clear that there was a real need for health economics expertise based within the department itself, and I was offered a permanent position in 1996.’ Professor Gray explained.

‘As the group began to grow, there was a risk that health economists would be scattered across different research institutes and I was keen to try and build a critical mass in one place. This way, researchers could develop long-term careers in health economics, and we could create teaching courses and other training opportunities for students to gain experience.’ Professor Gray said. The unit is now a thriving team of around 40 staff and students, which Professor Gray described as being ‘a very diverse, international group, who enjoy lots of socialising outside work!’

HERC’s research portfolio covers both international and UK-focused issues, with topics including health and social care services; infectious diseases; genomic technologies; and major chronic illnesses. The group frequently collaborates with other Oxford University departments, overseas health economics groups, and clinical trials research units, including those at the Universities of Birmingham, Bristol and Aberdeen. Recent research highlights have included evaluations of community-based ‘Hospital at Home’ healthcare models; the cost of self-harm in England; use of whole genome sequencing to diagnose rare diseases; and cost-effective treatments for deadly fungal infections in HIV patients. For Professor Gray, one of the unit’s most notable achievements has been to demonstrate that statin therapies are a highly cost-effective strategy to combat heart disease. ‘Our research clearly showed that statins are a very good investment in public health, with a huge payoff in terms of reducing the burden of heart disease.’

During the coronavirus pandemic, HERC pivoted rapidly to focus on urgent questions relating to COVID-19. At an international level, this involved embarking on the COVID-19 Vaccine Preference and Opinion Survey (CANDOUR study): an international survey involving more than 15,000 individuals across the world to better understand the public’s views on prioritisation and allocation of COVID-19 vaccines. Dr Koen Pouwels, meanwhile, became the co-investigator on the UK’s national COVID-19 Infection Survey; the world’s largest household study of the spread of coronavirus. The study includes more than half a million participants, and the results have directly informed Government policies on social distancing and local/national lockdowns.

HERC is also highly active in teaching. Besides supervising MSc and DPhil students and teaching on undergraduate courses, the unit also leads several short courses on health economics, which range from basic introductions to intense workshops for health professionals. HERC has also hosted conferences for the Health Economists’ Study Group, which brings together health economists from across the UK.

Much of HERC’s research has important implications for Government policies and healthcare provision, hence the unit engages with policy makers through various activities. These include contributing to Parliamentary briefing papers and landmark reports, such as Generation Genome, an influential report from the Chief Medical Officer examining how genomics can improve health and prevent ill-health.

Having stepped back as Director of HERC at the end of 2018, Professor Gray is confident his successor Professor Philip Clarke will lead it forward. ‘Reaching 25 years is quite an accomplishment, and the group’s strong reputation makes it well-placed to make further valuable contributions in the future.’

Professor Clarke, the current Director, indicated that HERC’s research will continue to evolve to address new questions, both for the United Kingdom and globally, with a wide range of collaborators. ‘Health economics by its nature is very much multi-disciplinary research. HERC has been instrumental in bringing together researchers from different disciplines, including a recent symposium to look at ways to best tackle COVID-19, which brought together researchers from across the University. In addition, HERC’s teaching now has a global reach, as its range of virtual courses have been attended by over 600 participants from across the world.’  

HERC will be holding an event later this week to both celebrate the first 25 years and plan for the future.