Professor Alastair Gray
Professor of Health Economics & Director, HERC
- Health Economics Research Centre
- NIHR Senior Investigator
My research focuses on the use of economics to improve resource allocation and decision making in health care. In particular, I am interested in using robust methods to estimate the likely cost-effectiveness of new and existing health care interventions. This may involve synthesising information from different sources on costs, outcomes and effectiveness in a decision-analytic model. But most commonly I work with clinicians and triallists to collect individual patient information within large randomised trials, typically assembling and analysing data on the cost of the intervention and the alternative, the outcomes in terms of quality of life and survival, and the cost-effectiveness in the trial and in routine care.
The economic evaluations I am involved in span many different clinical areas, from psychiatry to neurosurgery and care of the elderly. But I have particular interests in diabetes, orthopaedic surgery and population screening. These studies often involve the development and use of disease models, typically based on individual patient data, to predict lifetime costs and outcomes; my group has developed these in areas such as diabetes, cardiovascular disease, kidney disease and breast cancer.
Quality of life is a crucial aspect of much of my work, and so I am also interested in the methodologies used to measure and value different health states, different conceptions of quality of life, and the association between different quality of life measures.
Finally, I have a long-standing interest in wider economic aspects of health care, including the impact of demographic change and ageing populations on health systems, and the economics of health care errors and adverse events.
Teaching and training are a fundamental aspect of my work, and I typically am supervising 2-4 doctoral students as well as contributing to HERC’s short courses and the MSc Global Health Sciences.
Applied Methods of Cost-Effectiveness Analysis in Healthcare
Gray AM. et al, (2011)
UKPDS Outcomes Model 2: a new version of a model to simulate lifetime health outcomes of patients with type 2 diabetes mellitus using data from the 30 year United Kingdom Prospective Diabetes Study: UKPDS 82
Hayes AJ. et al, (2013), Diabetologia
Economic evaluation alongside randomised controlled trials: Design, conduct, analysis, and reporting
Petrou S. and Gray A., (2011), Bmj, 342
Rationing of total knee replacement: a cost-effectiveness analysis on a large trial data set.
Dakin H. et al, (2012), Bmj open, 2
A cluster randomized trial of strategies to increase uptake amongst young women invited for their first cervical screen: The STRATEGIC trial.
Kitchener H. et al, (2018), J med screen, 25, 88 - 98
What do we know about managing Dupuytren’s Disease cost-effectively?
Dritsaki M. et al, (2018), Bmc musculoskeletal disorders
Health system dynamics analysis of eyecare services in Trinidad and Tobago and progress towards Vision 2020 Goals.
Braithwaite T. et al, (2018), Health policy plan, 33, 70 - 84
Meta-analysis of the procedural risks of carotid endarterectomy and carotid artery stenting over time.
Lokuge K. et al, (2018), Br j surg, 105, 26 - 36
Modelling incremental benefits on complications rates when targeting lower HbA1c levels in people with Type 2 diabetes and cardiovascular disease.
Mostafa SA. et al, (2018), Diabet med, 35, 72 - 77