Is the NHS in crisis? What about health systems globally? If so, how do we deal with this in a way that protects the fundamental goals of a health system? What role does innovation have in this?

These were some of the questions posed at the Astellas Innovation Debate, which I attended last week. You can watch the full debate online, and that’s well worth doing if you have any interest in this area. The panel - two Brits, one an NHS senior manager (former Chief Exec of NHS England), the other a Professor (in my department!) and GP; a Dutch health exec and an American health economist - were a good mix. They all brought a slightly different perspective to what health care in the 21st century looks like, but the level of expertise was very high, meaning the debate didn’t get bogged down in the basics, but progressed at a rapid pace. And it had to - 90 minutes to get through one of the...

Let’s talk about biomarkers. Biomarkers are molecules found in the body, usually identified in the bloodstream or urine, that are the telltale traces of internal processes unfolding deep in our organs and cells. Different levels of these usually harmless byproducts can be used to flag up occasions when a patients symptoms may be something worth investigating, or alternatively rule out a given condition. Classic examples are human chorionic gonadotrophin (HCG), which is the biomarker measured in pregnancy tests, or blood glucose, which can indicate diabetes.

A couple of years ago, an American teenager called Jack Andraka won a major youth science prize by developing a blood test for a pancreatic cancer biomarker he had identified, mesothelin. Although, to my knowledge, the story hasn’t really moved on since then, it has recently started cropping up all over my newsfeeds. While it is an...

I am a health economist. A total newbie, four months into a shiny new career, and I want to write about it. Hopefully in a way that helps inform people, but also just for myself, as a way of taking a step back and looking at the big picture. It’s easy, in the day-to-day, to get caught up in the little detail of your tiny corner of the field. I’d hate to end up myopic. I’ve been meaning to start something like this for ages, but other things - including just a lack of drive - have had a tendency to get in the way. I also want to write because, although there are some great blogs on health economics, they tend to fall into a couple of categories, and I feel something is missing.

First, the specific, academic interests. My colleague, James Buchanan, writes an excellent blog on economic evaluation and genetics. He reviews papers and conferences and discusses his work and other points of...

The process of drug development is simple: research a compound, test it in clinical trials, publish the results, submit for approval, simmer for a few years and voila: cancer cured. However, it’s becoming increasingly apparent that one of those key steps is missing. Sure, trial results get published, but not all of them, not by any stretch of the imagination (one study puts the figure at 50%). And missing trials mean we can’t judge whether the drugs actually work.

Ben Goldacre and the All Trials campaign have been crucial in raising awareness of this. It is often presented as a clinical issue - that doctors can’t make effective decisions about individual patients, but it’s actually much broader than that. It’s the decision makers that come before the GP that are most affected, and it’s their decisions that have a bigger impact on patients. After all, how much time do you really think...