HP435 ASSESSMENT OVERVIEW:
POLICY REPORT


Summative assignment: 4,000-word policy report
(100% of your overall course mark; due 24 January 2023)

Formative assignment: 1,000-word outline of your report
(Not graded; due 28 November 2022)



There are many challenges in the world of access to medicines that remain
unsolved. This is your chance to investigate a contemporary policy issue that
interests you and to write up a report for policymakers on how to address it!


GENERAL REMARKS

The central aim of this assignment is for you to define a policy issue, summarize
what is known about the issue in the literature, and draft concrete policy
recommendations (based on your reading of the evidence). My hope is that, in the
process, you’ll sharpen both your critical analysis and writing skills.

This assignment will require you to break a complex problem into its component
parts. To do this, you’ll have to read extensively, think deeply about the problem
and potential solutions to it, and organize your thoughts coherently (probably
using a conceptual framework -- more on that below). You’ll need to take a
balanced look at the evidence when reaching policy conclusions. You should draw
on relevant theoretical and empirical studies to substantiate your policy position
and to show a strong and nuanced understanding of the topic.


TOPIC SELECTION

I’ve given you a choice of four topics at the end of this document (see pages 7-9).
You can pick any one of these. Alternatively, you can come up with your own
topic, as long as it’s of significant policy and academic relevance. If you decide to
choose your own topic, please run it by me before you get started with the
assignment (by the end of week 8 at the latest).

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For this assignment, I strongly recommend you focus on a policy issue in a
particular country (or, in some cases, a region). This will make it easier to keep
your analysis focused (i.e., adopt a national perspective) and nuanced, and you’ll
be able to direct your policy recommendations to national decision-makers.
However, there may be exceptions (e.g., global solutions to the lack of antibiotic
drug development) so feel free to discuss with me if you want to consider a topic
where it makes sense to widen the geographic scope.


ASSIGNMENT STRUCTURE

The report will consist of seven sections. The word count for each section is
indicative (and you can use different section heading sand sub-headings); it’s OK if
individual sections are a bit shorter or longer, as long as it all adds up to max 4,000
words.

1. Executive summary (200 words)
2. Background (500 words)
3. Policy problem (500 words)
4. What is known about the issue? (1500 words)
5. How should policymakers tackle the problem? (1000 words)
6. Conclusion (300 words)
7. References (maximum of 50 references -- this section doesn’t count towards
the word limit)

Here’s some additional information about what should go into each section.

1. Executive summary

– This should be a concise 1-paragraph summary of your policy report.
– You’ll need to distil the entire report into roughly 200 words, so think
carefully about what to cover in your summary.
– Use crisp language to give the reader a good first impression (this
goes for the rest of the text too but is especially important here).
– I’d write the executive summary last.

2. Background

– This section should set the scene and make clear why the topic is
important.
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– It’s usually a good idea to point to recent data to support your
statements. It’ll make your opening pitch more concrete and
compelling.

3. Policy problem

– This should be a concise summary of the issue at hand. But you still
need to demonstrate an awareness of nuances and complexities.
– Where relevant, you should consider the problem from the perspective
of different stakeholders.
– It may be helpful to draw on a conceptual framework to organise your
ideas. For instance, if you’re investigating the pricing of new,
expensive medicines in a particular country, then it could make sense
to use a framework around fair pricing (like the one covered in the
week 5 lecture).

4. What is known about the issue?

– This should be based on a literature review. I understand that you
won’t be able to conduct a systematic review of all the relevant
literature but be sure to do as thorough as job as possible. You should
have enough time to search key databases (PubMed/MEDLINE,
EconLit, Scopus, etc.) to make sure you capture much of the relevant
literature.
– Having said that, 1,500 words is obviously not enough space to go
through everything in detail. You’ll need to be concise and focus on
key issues. Where you decide to limit the scope of your analysis,
please let the reader know. This shows good awareness of the
complexity of the issue.
– Be sure to identify any gaps in our knowledge / where research does
not provide a definitive answer. You may wish to comment on the
quality of the available evidence.

5. How should policymakers tackle the problem?

– Here’s where you get to tell policymakers what they should consider
doing (whilst keeping your recommendations rooted in the best
available evidence).
– You should discuss potential obstacles to implementing the solutions;
obstacles may be logistical (e.g., lack of infrastructure), financial (e.g.,
lack of budget space), political (e.g., if policymakers are likely to face
stiff political headwinds from key stakeholders), societal (e.g.,
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potential lack of buy-in from members of the public for a particular
solution), etc.
– Where there is limited evidence, it is perfectly fine to review the likely
pros / cons of different options and discuss what additional evidence is
needed to draw more firm conclusions. This is preferable to strongly
advocating a position for which there is little supporting evidence.
That’s not to say the answer is always in the middle or that you can’t
take a position on an issue. But it is rare to find an important policy
issue with clear-cut solutions (or else the issue probably would have
been resolved already!).
– It’s also fine to support a position even if the evidence is not 100%
conclusive (it rarely is), but you’ll need to show that you arrived at
this conclusion based on an objective and balanced reading of the
evidence. And you should think through any potential unintended
consequences to your proposed solution(s).

6. Conclusion

– Write a punchy conclusion that reiterates the main take-aways.
– Use crisp language to leave a lasting impression on the reader.

7. References

– Even though this is a policy report, it should be written like an
academic essay with extensive and appropriate referencing.
– Feel free to use any referencing style (for the reference list and in-text
citations), as long as you’re consistent.
– Be sure to use a reference manager, it’ll make your life much easier! I
recommend Zotero (https://www.zotero.org).


FORMATIVE ASSIGNMENT: ESSAY OUTLINE (MAX 1,000 WORDS)

Your formative assignment will consist of two parts: an essay plan (500 words)
and annotated bibliography (500 words). The formative assignment is compulsory
but not marked. It’s an opportunity for you to get feedback that you can build on
when writing up the final report.

The essay plan should be a skeleton of your policy report, with some preliminary
text for each section to indicate the direction of travel (you can skip the executive
summary / conclusion sections, since you won’t have gotten that far yet).

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For the annotated bibliography, please identify five research articles that are
highly relevant to your report and then provide a concise summary of each piece of
evidence and how it relates to your report. You may wish to answer the following
questions:

– What research question were the authors trying to answer?
– Did they draw on a conceptual framework?
– What were the main results and conclusions of the study? What were
the main limitations of the analysis / sources of uncertainty?


MARKING

I’ll be following the departmental marking framework when grading your
summative assignments, so please familiarize yourself with the framework (which
I’ve uploaded to Moodle).

The word limit will be strictly enforced, and you’ll lose points if your submission
exceeds the limit.

Here are a few things that set distinction-level reports apart from other
submissions:

– A clear and compelling introduction that highlights why the topic is
important. If your friends or family members (who aren’t studying in a
health policy dept!) were to read the introduction, they’d immediately
understand why it’s critical we tackle the issue at hand.
– A concise yet comprehensive overview of the issue at hand. This should
demonstrate a strong understanding of the nuances and complexities of the
problem. If you feel that you’re only able to tackle a problem at a very
superficial level, then it’s best to narrow the scope of the analysis.
– A well-researched report that draws on relevant theoretical and empirical
literature to substantiate claims and policy suggestions. Distinction-level
reports feel like they’re written by experts on a topic.
– A balanced outline and discussion of policy options; the author pays
particular attention to the drawbacks of each option, and where further
evidence is needed. The author clearly states their recommendation.
– The report is well written, with a clear structure and flow.
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WRITING TIPS

You may want to take a look at this useful writing guide put together by Daniel J
Simmons, a professor at the University of Illinois (Urbana-Champaign):
http://www.dansimons.com/resources/Simons_on_writing_1.5.pdf

While some of Simmons’ suggestions are not directly applicable to this assignment
(for instance, certain examples relate to science writing), the guide provides many
excellent tips on how to improve your writing. Here are a few key suggestions
(paraphrased):

– Place key arguments at the top of paragraphs (think of it this way: someone
should be able to read the 1st sentence of each paragraph in your report and
get the gist of your paper / arguments).
– Make sure the transition from one paragraph to the next is easy to follow.
– Write short sentences (they help improve the flow and clarity of your text).
– Explain concepts in simple terms. Avoid technical jargon / acronyms
whenever possible (and if you do need to use acronyms, limit yourself to a
few essential ones).


PLAGIARISM

All students should familiarize themselves with school regulations around
plagiarism.

http://www.lse.ac.uk/health-policy/current-students/plagiarism

All forms of plagiarism, including self-plagiarism, are taken very seriously.
Submitted assignments are checked for plagiarism using an online detection
service (TurnitinTM), and suspected cases of plagiarism are forwarded to
departmental or university committees, as appropriate, for review.

Each year we observe instances of academic misconduct. Dealing with such cases
is one of the most disappointing parts of being an academic. It inevitably leads to
frustration and distress for all involved parties, so please do not plagiarise or
commit any form of academic misconduct. If you have questions about how to
paraphrase a text or how to appropriately quote or reference material, please do
not hesitate to come to speak to me about it.
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SUGGESTED TOPICS

Here are a few suggested topics. I’ve tried not to be too prescriptive in how you
should tackle these policy issues in your report.

You may choose to focus on specific aspects as you see fit (i.e., narrow the scope
of your analysis). You can also choose to focus on a similar case in a different
country.


1. Not so Sunny in Thailand: Pharmaceuticals, Profits, and Patents

The World Trade Organization’s TRIPS Agreement gives governments the
right to issue compulsory licenses for medicines. Akin to the concept of
expropriation, in which a government can seize control of private property for
public use—to build a railroad, for instance—a government can grant a
compulsory license to an organization that is not the patent holder. This
license gives the third party the right to produce and sell copies of the patented
technology so long as it is predominantly for domestic use.

After the Thai Government issued compulsory licenses for several HIV and
heart-disease drugs in the mid-2000s., the prices of these essential medicines
dropped sharply. Supporters cited this as evidence that compulsory licenses
improve access to essential medicines. Critics countered that the widespread
use of compulsory licenses in Thailand and elsewhere would stifle innovation.

This project will have you investigate the pros and cons of compulsory
licensing (i.e., breaking patents) in Thailand from the perspective of different
stakeholders. You may wish to outline a conceptual framework for how you
propose to evaluate the use of such licenses.



2. A Bitter Pill to Swallow: The $84,000 Cure for Hepatitis C

Sovaldi (sofosbuvir) is a highly effective treatment for hepatitis C, developed
by the company Gilead Sciences. The US Food and Drug Administration
approved the drug for medical use in December 2013, and the company
launched the product in the United States with a sticker price of $84,000 per
course of treatment. At the time, it was one of the most expensive drugs on the
planet.

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While several analyses deemed the drug to be cost-effective at this price, most
countries, including the US, struggled to pay for the drug because of its
immense budget impact. Many governments had to restrict coverage of the
drug to a small number of individuals.

For this topic, you should explore the pricing of Sovaldi in the United States to
understand the policy and economic issues around this case: Was the price that
the company asked for reasonable? What affordability issues did it pose? What
new policies were proposed by the US Government (in some cases, individual
state governments) to finance this product (and follow-on hepatitis C
products)? Were these alternative financing models successful?

You may wish to outline a conceptual framework for how you propose to
evaluate what is a fair drug price and what mechanisms might achieve fair
drug prices.



3. The Scourge of Fake Drugs: How to Eliminate Substandard and
Falsified Medicines?

Many of us take for granted how lucky we are to be able to go to a pharmacy,
fill a prescription, and be reasonably sure that we’ll receive exactly what the
doctor prescribed us. Yet for many people around the world, the reality is
starkly different. The World Health Organization recently estimated that
roughly 1 in 10 medicines consumed around the world are falsified or of
substandard quality.

For this assignment you can pick a country of your choice and analyse the
prevalence and economic burden of substandard and falsified medicines in the
country. You should conduct a thorough examination of the policy challenge
and propose ways forward for the government to reduce the prevalence of
falsified or poor-quality medicines.

It will be important to draw on a conceptual framework to organize the factors
that contribute to the existence of poor-quality medicines on the market, which
may range from corruption to inadequate regulation and oversight of
distribution chains.



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4. Existential Angst: The Lack of Antibiotics in Our Therapeutic
Arsenal Against Superbugs

The World Health Organization recently labelled antimicrobial resistance as
one of ten top threats to global health. The Review on Antimicrobial Resistance
(a report commissioned by the UK Govt) makes for a harrowing read: When
the report came out in 2016, the authors estimated that antimicrobial
resistance killed around 700,000 people around the world each year, and that
the figure could jump to 10 million per year by 2050.

Over the past few decades, most drug companies have abandoned their
antibiotic pipelines in favour of more lucrative targets, like cancer drugs. This
is in part because most low-hanging fruits have been picked (so it’s more costly
to develop new antibiotics) and, even if a company were to be successful,
physicians would be incentivized to keep any new antibiotic as a measure of
last resort to prevent further resistance (which would lead to lower sales
revenues for companies).

For this topic, pick a country of your choice and analyse potential strategies
that the government of that country could adopt to promote the development of
new antibiotics. You may wish to consider a regional bloc of countries (or even
an international consortium or initiative), since this is a cross-border threat
that requires a coordinated response.