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Health economics

Cedar has expertise and experience in health economics. Megan Dale is our lead Health Economist. We are contracted by NICE to critique and amend company-submitted economic evaluations for the Medical Technologies Evaluation Programme. We work in partnership with Swansea Centre for Health Economics SCHE based in Swansea University.

Cedar's health economic projects


OBS Cymru

OBS Cymru was a three year national quality improvement project that aimed to standardise care and reduce both morbidity and mortality rates associated with postpartum haemorrhage (PPH) across all Welsh maternity settings. The improvements in care have now been embedded in maternity units across Wales. Cedar carried out an economic evaluation using data collected during the project that demonstrated consistent savings in blood product use, crucial care utilisation and haematology consultant time. The evaluation considered the impact of maternity unit size and the uptake of the intervention. More information is available here.

Dale, M., Bell, S., Scarr, C., Collis, R. James K Carolan-Rees G., Collins P. (2020) OBS Cymru: a health economic evaluation. Obstetric Anasesthetists Association Conference, P1. Available from: Accessed February 2021

Dale, M., Bell, S., Scarr, C., Collis, R. James K Carolan-Rees G., Collins P. (2020) OBS Cymru: a health economic evaluation. International Journal of Obstetric Anaesthesia. Vol 44, Supplement 1. S1-S62. Available at Accessed February 2021


Selective internal radiation therapy

NHS England commissioned a full economic evaluation of selective internal radiation therapy for the treatment of advanced liver metastases.

White J., Dale M., Morgan H., Sewell B., Carolan-Rees G. (2017) Commissioning through Evaluation: Selective internal radiation therapy (SIRT). NICE Commissioned report for NHS England 2017. Available at:


Oral health in care homes

On behalf of NICE, Cedar carried out an economic evaluation on oral health in care homes.

Cleves A, Jones M, Morgan H, Fitzsimmons D, Alam F. (2016) Economic report: Oral health for adults in care homes. Available at:


Transmission - Radiotherapy Active Pixel System (TRAPS)

Cedar completed a health economic cost comparison of a novel method to measure patient dose during radiotherapy, compared to existing alternatives. A functional model was produced to enable exploration of the device in different pathways and settings. Project II-LA-0214-20004 was funded by the NIHR as part of the Invention for Innovation (I4I0 funding scheme. Discussions are now taking place between the project team and two commercial companies to determine whether it will be feasible to take the device forward into development.  The project team have expressed their appreciation for the cost comparison model as a starting point for discussion of the financial aspects.


Pressure Ulcer Prevention and Intervention Service, South West (PUPIS)

The PUPIS SW project brought together people from different clinical specialities and resulted in sharing ideas and building new links between people. Cedar evaluated and reported on the Pressure Ulcer Outreach Service in Salisbury, and compared different models of equipment provision. 

Dale M., Cox-Martin B., Shaw P., Carolan-Rees G. (2014) Cost-effective non-surgical treatment of chronic pressure ulcers in the community. British Journal of Community Nursing, Vol. 19, Iss. Sup1, 07, pp S6 - S12


Operative hysteroscopy outpatient clinic (Health Foundation Shine Award)

Led by Mr Richard Penketh (Consultant Obstetrician and Gynaecologist) the Cardiff Shine team established an operative hysteroscopy outpatient clinic for treatment of uterine fibroids and polyps under local anaesthetic using reusable equipment. This procedure is conventionally done in surgical theatres under general anaesthetic which is inconvenient for patients, has associated risks, and has a high resource-use burden. Cedar carried out independent patient satisfaction phone interviews, analysis of the clinical data, and an economic evaluation of the clinic compared to standard care under general anaesthetic in theatres.

Penketh R.J.A., Bruen E.M., White J., Griffiths A.N., Patwardhan A., Lindsay P., Hill S., Carolan-Rees G. (2014) Feasibility of resectoscopic operative hysteroscopy in a UK outpatient clinic using local anaesthetic and traditional reusable equipment, with patient experiences and comparative cost analysis. Journal of Minimally Invasive Gynaecology Sep-Oct;21(5):830-6.