Professor Sue Jowett PhD, MSc, BSc

Professor Sue Jowett

Institute of Applied Health Research
Professor of Health Economics
Deputy Head of Health Economics Unit

Contact details

Address
Health Economics Unit
Institute of Applied Health Research
IOEM Building
University of Birmingham
Edgbaston
Birmingham, B15 2TT

Sue Jowett is a Professor in the Health Economics Unit (HEU) with an extensive portfolio of applied research concerning trial and model-based economic evaluations in chronic diseases. Sue also oversees health economics research within studies undertaken by Primary Care researchers in the School of Medicine at Keele University, as part of a formal collaboration between the HEU and Keele. Sue also collaborates on a large number of projects at the University of Birmingham and is the health economics lead and co-investigator on over 20 major grants, the majority funded by the NIHR Health Technology Assessment and Programme Grant for Applied Research funding streams. Sue is also involved in several environmentally-focused studies, including the NERC-funded WM-AIR programme of work on air pollution in the West Midlands, where she leads the economic component of the health strand. Whilst most of her work has a UK focus, more recent work has considered chronic disease detection and management in LMICs.

Sue has published a large number of economic evaluations in the area of chronic disease prevention and treatment in a community care setting. Her principal clinical areas are musculoskeletal disease, chronic obstructive pulmonary disease (COPD), primary and secondary cardiovascular disease prevention, acute stroke care, liver disease and venous thromboembolism.

Sue teaches health economics, particularly in the area of economic evaluation methodology including decision modelling, to students on the HEU’s MSc in Health Economics and Health Policy, as well as teaching on health economics modules for the MPH and MSc in Genomic Medicine.

Qualifications

  • PhD in Health Economics, University of Birmingham, 2007
  • MSc Applied Meteorology and Climatology, University of Birmingham, 1995
  • BSc (Hons) Geography, University of Bristol, 1993

Biography

Sue Jowett qualified with a BSc in Geography from the University of Bristol in 1993 and completed an MSc in Applied Meteorology and Climatology at the University of Birmingham in 1995. A change of direction led Sue to join Primary Care Clinical Sciences at Birmingham in 1995 as a Research Associate and became a Research Fellow in 2001, undertaking health economic evaluations in collaboration with the Health Economics Unit (HEU).

In 2004 Sue moved to HEU and studied part-time for a PhD in Health Economics, gained in 2007. In 2010 she was appointed to a Senior Lecturer position to lead the health economics research within studies undertaken by the Arthritis Research UK Primary Care Centre at Keele University, as part of a formal collaboration between the HEU and Keele. She successfully gained a permanent HEFCE Senior Lecturer post in 2013 and was promoted to Reader in 2017. Sue was promoted to Professor in 2021.

The majority of Sue’s work to date has been in the area of economic evaluation alongside interventions for the prevention of cardiovascular disease, and management of musculoskeletal disease. Her initial health economics research was on three large clinical trials concerning AF and anticoagulation, and expertise gained in this area led to further collaboration with colleagues at Birmingham, Oxford and Cambridge. Sue advised the NICE Guidelines Development Group on the modelling undertaken for blood pressure diagnosis for their Hypertension Guidelines.

As lead of the collaboration with Keele, Sue oversees the health economics aspects many trials and cohort studies and is the lead health economist on research grant applications.

Sue has been a health economics co-applicant on a many successful research grants including ten National Institute for Health Research (NIHR) Programme Grants in chronic diseases and she has also been involved in a large number of Health Technology Assessment (HTA) funded studies concerning areas such as COPD, musculoskeletal conditions, liver disease, and management of acute stroke. She has also been a co-investigator on three Global Health projects in COPD and atrial fibrillation. More recent work has linked back to her original qualifications in geography and climatology, including a NERC-funded grant on air pollution in the West Midlands, a Wellcome Trust grant on the health implications of Net-Zero policies and two NIHR grants exploring carbon reduction on both surgery and primary care.

Teaching

Postgraduate supervision

Sue has successfully supervised 7 PhD students to completion and currently supervises 3 PhD students in the topic areas of Surgical Site Infection prevention in LMICs, Delegation in Musculoskeletal Outpatient Physiotherapy and Decision-analytical modelling to estimate economic implications of population obesity and preventative actions on local authority budgets

Sue is primarily interested in supervising doctoral research students in the following areas:

  • Decision modelling in economic evaluation
  • Trial-based economic evaluation
  • Aspects of economic evaluation in chronic disease (COPD, musculoskeletal disease, cardiovascular disease)
  • Application of health economics to environmental issues (e.g. air pollution, Net-Zero)

Research

Cardiovascular disease and anticoagulation

Sue has worked on numerous projects in the clinical topics of cardiovascular disease and anticoagulation since embarking on a career in health economics in 2001.

She advised on the modelling of the long-term cost-effectiveness of blood pressure diagnosis which was published in the Lancet and formed part of the NICE hypertension guidelines.  In collaboration with Oxford University, Sue has led the economic component on a number of studies on the diagnosis and management of hypertension in primary care, with an emphasis on self-monitoring, including the TASMINH, TASMIN2 & TASMIN-SR trials. More recently the TASMINH4 trial and the PROOF-BP study have had results published in The Lancet and Hypertension, and the OPTIMISE trial, which explored reducing antihypertension medication in the elderly was published in JAMA and Hypertension. Two global health studies, Global AF Reach  which undertook research into atrial fibrillation (AF) in Sri Lanka, Brazil and China, and Treats-AF which investigated an educational intervention for anticoagulation therapy in AF patients in Thailand are both completed and being written up for publication.

Sue’s current projects in this clinical area include the MAPS-2 trial (metoclopramide to prevent pneumonia after stroke), ABBRUPT, which looks at treatment for new onset AF in acute care settings and a NIHR programme grant concerning an intervention for post-stroke fatigue.

Musculoskeletal disease

Sue leads the health economics portfolio of research conducted in collaboration with Primary Care researchers at  Keele University on a wide variety of musculoskeletal disorders.  Core areas of research concern stratified care, osteoarthritis (OA) and inflammatory conditions. This long-standing research partnership has led to a number of key publications, for example the INSTINCTS trial, published in the Lancet, is the largest trial undertaken of corticosteroid injection compared with night splints for the relatively common but painful problem of carpal tunnel syndrome, and the first study to include a health economics analysis of these interventions.

Whilst the work with Keele has traditionally focussed on trial based economic evaluation, Sue has ensured that more recent work also includes a decision model-based evaluation to explore longer-term cost-effectiveness. Two NIHR Programme Grants containing trial and model-based economic evaluations are ongoing, concerning the use of prognostic and diagnostic information for targeting treatment in shoulder pain (PANDA-S) and a pharmacist-led primary care intervention for opioid-treated persistent non-cancer pain (PROMPPT). Three NIHR-funded trials HTA are also in progress on knee-braces for knee OA (PROP-OA), an allopurinol-based treat-to-target protocol for recurrent gout (T2T) and a vocational advice service for return to work (WAVE).

A new Programme Grant, CAM-PAIN, will determine the longer-term outcomes of child/adolescent musculoskeletal pain in primary care by describing overall prognosis, identifying prognostic factors, and estimating health service costs of children/adolescents presenting with new musculoskeletal pain, using Clinical Practice Research Datalink (CPRD) data. Additional new studies in their set up phase are FORENSIC assessing the effectiveness of lumbar fusion in severe low back pain and IDEAL, which will evaluate the diagnosis and Early referral of patients with AxiaL Spondyloarthiritis.

Three Keele-funded PhDs (with co-supervision from Sue) have been completed successfully on optimal care for OA, absenteeism and presenteeism in back pain patients and the use of decision modelling in the assessment of cost-effectiveness of stratified care in musculoskeletal disease.

Respiratory disease

Sue leads the health economics research on the programme of respiratory disease work, primarily concerning chronic obstructive pulmonary disease (COPD), led by colleagues within the Institute.

There are two NIHR-funded trials in this area with one assessing an intervention to manage acute exacerbations in COPD (Predict & Prevent), and one concerning smoking cessation with electronic cigarettes in COPD (ECal). Previous work includes Breathewell, an NIHR-funded Global Health programme of work of case finding and management of COPD in Brazil, China, Georgia and North Macedonia, and health economics is an integral component of the research in all four countries, and the TARGET-COPD case finding trial containing a within-trial and beyond-trial economic evaluation. The clinical trial has been published in Lancet Respiratory Medicine and the model-based analysis, the first of its kind, was published in Thorax.

Air pollution and Net-Zero

Bringing together her expertise in respiratory and cardiovascular disease, Sue is a co-investigator on WM-Air, a cross-College collaboration with the College of Life and Environmental Sciences, which secured £5m in funding from the NERC Regional Impact from Science of the Environment (RISE) Programme. The West Midlands Air Quality Improvement Programme (WM-AIR) includes a health strand, and Sue has led the development of a health economics-based toolkit for use by local public health decision makers (AQ-LAT). This downloadable web-based toolkit provides local estimates of how effective air pollution mitigation strategies will be in terms of reduction in mortality and morbidity, quality of life and health care resource use and costs. Sue is also part of the WM-Net Zero project, funded by the Wellcome Trust. This builds on the AQ-LAT modelling and will explore the health impacts of Net Zero polices. She is also a co-investigator on two new Net Zero studies, looking at decarbonisation in General Practice (GPNET-0, Warwick University) and the GreenSurg Programme, a £2.5m NIHR Programme Grant looking at interventions to reduce the carbon footprint of surgery.

Liver disease

More recently, Sue has become involved in Birmingham-led NIHR HTA trials concerning liver cirrhosis. CALIBRE compares carvedilol with variceal band ligation for the primary prevention of variceal bleeding in liver cirrhosis, and REACT-AVB compares Early transjugular intrahepatic portosystemic stent-shunt (TIPSS) in acute variceal bleeding.

Other activities

External Examiner

  • Executive MSc in Health Economics, Outcomes and Management in Cardiovascular Sciences, Department of Social Policy, London School of Economics (2016-2021)
  • MSc in Health Research, Warwick Medical School, Warwick University (2017-2021)

Steering Committees

  • Member of the Trial Steering Committee for the Optimising Prescription of Treatment In older patients with Mild hypertension at Increased risk of Serious adverse Events (OPTIMISE2) trial. Funded by the NIHR HTA programme. (Lead: Dr James Sheppard, University of Oxford) (2022-)
  • Member of the Trial Steering Committee for the iRehab trial:Remote multicomponent rehabilitation intervention in survivors of critical illness post hospital discharge: a randomised controlled assessor blind clinical and cost effectiveness trial with internal pilot. Funded by the NIHR HTA programme. (Leads: Professor Danny McAuley (Queen’s University Belfast) and Dr Brenda O’Neill (Ulster University) (2022-)
  • Member of the Trial Steering Committee for the PART trial: The clinical and cost-effectiveness of elective primary total knee replacement with PAtellar Resurfacing compared to selective patellar resurfacing. A pragmatic multicentre randomised controlled Trial with blinding (PART). Leads: Professor Ashley Blom & Dr Gulraj Matharu (University of Bristol) (2022-)
  • Member of the Trial Steering Committee for the DEFINE trial: Determining the Effectiveness of a FeNO-guided asthma management intervention in primary care: a pragmatic randomised controlled trial with nested economic and process evaluations. Funded by the NIHR Programme for Applied Research. (Lead: Dr Kay Wang, University of Oxford) (2021-)
  • Member of the WHiTE Platform Joint Oversight Committee and Trial Steering Committee for FRUITI (Fix or Replace Undisplaced Intracapsular fractures Trial of Interventions). Funded by the NIHR HTA programme. (Lead: Dr Xavier Griffin, University of Oxford) (2020-)
  • Member of the Trial Steering Committee for the RISAPS trial: Rivaroxaban versus warfarin for stroke patients with antiphospholipid syndrome, with or without SLE (RISAPS): a randomised, controlled, phase II/III non-inferiority trial. Funded by Arthritis Research UK. (Lead: Dr Hannah Cohen, University College London) (2018-present)
  • Member of the Trial Steering Committee for the ARTISAN trial: Acute Rehabilitation following traumatic anterior shoulder dislocation. Funded by the NIHR HTA programme. (Lead: Professor Rebecca Kearney, University of Warwick) (2018-2023)
  • Member of the Trial Steering Committee for the GRASP trial:  Clinical and cost effectiveness of progressive exercise compared to best practice advice, with or without corticosteroid injection, for the treatment of rotator cuff disorders: a 2x2 factorial randomised controlled trial. Funded by the NIHR HTA programme. (Lead: Professor Sallie Lamb, Oxford University) (2018-2020)
  • Member of the Study Steering Committee for the NIHR HS&DR project “Innovations in major system reconfiguration in England: a study of the effectiveness, acceptability and processes of implementation of different models of stroke care” (Lead Professor Naomi Fulop, UCL) (2013-2017)

Funding Committees

  • Member of the NIHR HTA Clinical Evaluation and Trials Funding Committee (2016-2020)
  • Member of the West Midlands Research for Patient Benefit (RfPB) funding committee (2012-2015)

Professional membership

  • Member of the UK Health Economics Study Group (HESG)
  • Member of the International Health Economics Association (IHEA)

Publications

Recent publications

Article

Fernandes, G, Williams, S, Adab, P, Gale, N, de Jong, C, Correia-de-Sousa, J, Cheng, KK, Chi, C, Cooper, BG, Dickens, AP, Enocson, A, Farley, A, Jolly, K, Jowett, S, Maglakelidze, M, Maghlakelidze, T, Martins, S, Sitch, A, Stamenova, A, Stavrikj, K, Stelmach, R, Turner, A, Pan, Z, Pang, H, Zhang, J & Jordan, RE 2024, 'Engaging stakeholders to level up COPD care in LMICs: lessons learned from the "Breathe Well" programme in Brazil, China, Georgia, and North Macedonia', BMC Health Services Research, vol. 24, no. 1, 66. https://doi.org/10.1186/s12913-023-10525-4

Lasserson, D, Gaddu, P, Mehta, S, Ignatowicz, A, Greenfield, S, Prince, C, Cummins, C, Robinson, G, Rodrigues, J, Noble, S, Jowett, S, Toshner, M, Newnham, M & Turner, A 2024, 'Stopping anticoagulation for isolated or incidental pulmonary embolism: the STOPAPE RCT protocol', NIHR Journals Library. <https://www.journalslibrary.nihr.ac.uk/journals/>

Tripathi, D, Patch, D, Mehrzad, H, Yu, D, Aspinall, RJ, Armstrong, MJ, Stanley, AJ, Ireland, H, Travis, S, Hayes, P, Lomax, M, Roslund, N, Lam, E, Slinn, G, Jowett, S, Moakes, C, Maher, A, Brettell, E, Sehmi, S & REACT-AVB trial collaborative group 2024, 'Study protocol for a Randomised controlled trial of EArly transjugular intrahepatiC porTosystemic stent–shunt in Acute Variceal Bleeding (REACT-AVB trial)', BMJ Open Gastroenterology, vol. 11, no. 1, e001314. https://doi.org/10.1136/bmjgast-2023-001314

Oppong, R, Lewis, M, Campbell, P, Dunn, KM, Foster, N, Hill, J & Jowett, S 2023, 'Comparison of healthcare utilisation, costs and health related quality of life across the subgroups defined by the Keele STarT MSK Tool', Rheumatology, vol. 62, no. 6, pp. 2076–2082. https://doi.org/10.1093/rheumatology/keac560

Sarigiovannis, P, Foster, NE, Jowett, S & Saunders, B 2023, 'Developing a best-practice framework for Musculoskeletal Outpatient Physiotherapy Delegation: the MOPeD mixed methods research study protocol', BMJ open, vol. 13, no. 3, e072989. https://doi.org/10.1136/bmjopen-2023-072989

Sahbudin, I, Singh, R, Trickey, J, Baranskaya, A, Tracy, A, Raza, K, Filer, A, Jowett, S & Boonen, A 2023, 'Is symptom duration before DMARD therapy a determinant of direct and indirect costs in DMARD-naïve RA patients?', Rheumatology Advances in Practice, vol. 7, no. 2, rkad040. https://doi.org/10.1093/rap/rkad040

Kaur, D, Mehta, RL, Jarrett, H, Jowett, S, Gale, N, Turner, A, Spiteri, M & Patel, N 2023, 'Phase III, two arm, multi-centre, open label, parallel-group randomised designed clinical investigation of the use of a personalised early warning decision support system to predict and prevent acute exacerbations of chronic obstructive pulmonary disease: ‘Predict & Prevent AECOPD’ – study protocol', BMJ open, vol. 13, no. 3, e061050. https://doi.org/10.1136/bmjopen-2022-061050

Gjorgjievski, D, Stavrikj, K, Jordan, R, Adab, P, Stanoevski, G, Stamenova, A, Krstevska, E, Simonovska, S, Trpcheski, F, Adams, R, Easter, C, Rai, K, Cheng, KK, Chi, C, Cooper, BG, Correia-de-Sousa, J, Dickens, AP, Enocson, A, Gale, N, Jolly, K, Jowett, S, Maglakelidze, M, Maghlakelidze, T, Martins, S, Sitch, A, Stelmach, R, Turner, A, Williams, S & Farley, A 2023, 'Randomised controlled trial testing effectiveness of feedback about lung age or exhaled CO combined with very brief advice for smoking cessation compared to very brief advice alone in North Macedonia: findings from the Breathe Well group', BMC Public Health, vol. 23, no. 1, 1887. https://doi.org/10.1186/s12889-023-16644-1

Monahan, M, Glasbey, J, Roberts, T, Jowett, S, Pinkney, T, Bhangu, A, Morton, D, la Medina, ARD, Ghosh, D, Ademuyiwa, AO, Ntirenganya, F & Tabiri, S 2023, 'The costs of surgical site infection after abdominal surgery in middle income countries: Key resource use In Wound Infection (KIWI) study', The Journal of hospital infection, vol. 136, pp. 38-44. https://doi.org/10.1016/j.jhin.2023.03.023

Burton, C, Rathod-Mistry, T, Blackburn, S, Blagojevic-Bucknall, M, Chesterton, LS, Davenport, G, Dziedzic, K, Higginbottom , A, Jowett, S, Myers, H, Oppong, R, van der Windt, D, Hay, E & Roddy, E 2023, 'The effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome: 24-month follow-up of a randomised trial', Rheumatology, vol. 62, no. 2, keac219. https://doi.org/10.1093/rheumatology/keac219

Martins, SM, Dickens, A, Salibe-Filho , W, Albuquerque Neto , AA, Adab, P, Enocson, A, Cooper, BG, Sousa, LVA, Sitch, A, Jowett, S, Adams, R, Cheng, KK, Chi, C, Correia-de-Sousa, J, Farley, A, Gale, N, Jolly, K, Maglakelidze, M, Maghlakelidze, T, Stavrikj, K, Turner, A, Williams, S, Jordan, R & Stelmach, R 2022, 'Accuracy and economic evaluation of different screening tests and their combinations for undiagnosed COPD among people with hypertension in Brazil', NPJ Primary Care Respiratory Medicine, vol. 32, 55 . https://doi.org/10.1038/s41533-022-00303-w

Pang, H, Pan, Z, Adams, R, Duncan, E, Chi, C, Kong, X, Adab, P, Cheng, KK, Cooper, B, Correia-de-Sousa, J, Dickens, A, Enocson, A, Farley, A, Gale, N, Jolly, K, Jowett, S, Maglakelidze, M, Maglakelidze, T, Martins, S, Sitch, A, Stavrikj, K, Stelmach, R, Turner, A, Williams, S & Jordan, R 2022, 'Community lung health service design for COPD patients in China by the Breathe Well group', NPJ Primary Care Respiratory Medicine, vol. 32, no. 1, 27. https://doi.org/10.1038/s41533-022-00286-8

Jowett, S, Kodabuckus, S, Ford, GA, Hobbs, R, Lown, M, Mant, J, Payne, R, McManus, R, Sheppard, J & OPTiMISE investigators 2022, 'Cost-effectiveness of antihypertensive deprescribing in primary care: a Markov modelling study using data from the OPTiMISE trial', Hypertension, vol. 79, no. 5, pp. 1122-1131. https://doi.org/10.1161/HYPERTENSIONAHA.121.18726

Letter

Prior, JA, Roddy, E, Solis-Trapala, I, Cornwall, N, Jinks, C, Abhishek, A, Bukhari, M, Galloway, J, Goodson, N, Jowett, S & Hider, S 2023, 'How do clinicians prescribe bridging glucocorticoids in people starting or escalating disease-modifying anti-rheumatic drugs for rheumatoid arthritis: a service evaluation survey', Rheumatology Advances in Practice, vol. 7, no. 3, rkad102. https://doi.org/10.1093/rap/rkad102

Other report

Hall, J, Zhong, J, Harrison, R, Baldo, C, Jowett, S, Mazzeo, A & Bartington, S 2023, Health impacts of air pollution in Birmingham. University of Birmingham. https://doi.org/10.25500/DFAR-M070

View all publications in research portal

Expertise

Health Economics