Health systemsHAPIOR (Health Protection and Improvement with Operational Research)

HAPIOR (Health Protection and Improvement with Operational Research) is a responsive research facility funded by the UK Department of Health and Social Care (DHSC).

In this project we are researching policy questions related to antimicrobial resistance, immunisations, non-standard factors in cost-utility analysis, and other priority setting issues. We have also conducted a small amount of work on Covid-19. We are collaborating in the project with University College London and OPERA (Health Research Policy Research Programme in Operational Research), at the University of Manchester.

Antimicrobial resistance

Current Health Technology Assessment (HTA) methods capture the private value and ignore the societal value associated with novel antimicrobial treatment, reducing manufacturers’ incentive to invest in these technologies. The UK government and other countries are considering new payment models to overcome the market failures that have led to lack of development of antibiotics.

We are conducting work to estimate the private and societal values of novel antibiotics and to advise on a subscription payment model for antibiotics. The work involves mathematical modelling, expert elicitation, and development of tools for DHSC.


We are exploring methodology for disinvestment in public health programmes. We are looking at this in the lens of disinvestment in an immunisation programme, and we are exploring:

  1. what challenges present epidemiological modelling, health economic analysis and the application of decision rules
  2. how the decision rule for investment can be used to give a decision rule for disinvestment that is consistent in intent
  3. consider the extent to which any systematic process of periodic review of public health programmes could create theoretical internal inconsistencies with the assumed decision and time horizon taken in modelling to inform investment decisions

Non-standard factors in cost-utility analysis

There is ongoing debate about which dimensions of value should be included in economic assessments of vaccines.  We have developed visual tools as a framework to aid considering non-standard factors in economic evaluations.