Mr Mark Monahan B.Comm, MSc

Mr Mark Monahan

Institute of Applied Health Research
Research Fellow

Contact details

Health Economics Unit
Public Health Building
B15 2TT

Mark has been working in the Health Economics Unit since November 2013. He is also affiliated with the National Institute of Health Research (NIHR) Unit on Global Surgery where he provides health economic input to the global surgery programme.

Mark is currently doing a PhD on exploring modelling methods for informing resource allocation decisions in Lower Middle Income Countries within the surgical context. His supervisors are Professor Tracy Roberts, Dr Sue Jowett and Mr Tom Pinkney.

In 2018, Mark was invited to speak to an All-Party Parliamentary Group on Micronutrients and Health in the Palace of Westminster. The subject of the meeting was on ‘Healthcare Cost Savings from Food Supplements.’ Mark presented previous research, published in the Lancet Diabetes and Endocrinology, on the potential cost savings of iodine supplementation to pregnant women.


  • MSc (Health Economics), National University of Ireland Galway (NUI Galway), 2013
  • BComm (Commerce) International Experience, National University of Ireland Galway (NUI Galway), 2012


After completing an MSc in Health Economics in the National University of Ireland, Galway, Mark joined the Health Economics Unit at the University of Birmingham in November 2013.

Previous research has primarily been economic evaluations using decision analytic modelling to assess the cost-effectiveness of clinical decisions rules in areas such as Hypertension screening, Heart Failure screening, and idiopathic Venous Thromboembolism (VTE) treatment decisions. Mark is experienced in building decision trees and Markov models (cohort & patient-level simulation).

Currently working as a health economist on the NIHR Unit on Global Surgery. The unit aims to create a sustainable platform of frontline clinicians, prioritising and delivering research that will challenge and change surgical care relevant to patients in low and middle income countries (LMICs).

Mark is an MSc module coordinator for Modelling for Health Economics.



Current Research

Mark is currently working in the NIHR unit on Global Surgery. The unit aims to build research capacity and infrastructure in partner countries ensuring long term sustainability of high quality research, and ultimately improving surgical outcomes for patients around the world.

Every year an NIHR hub centre will host a Research Prioritisation Workshop where surgical researchers, healthcare professionals and policy makers meet to discuss research themes and priorities. The outcomes from these workshops form the basis of future cohort studies, leading ultimately to international, multi-centre randomised controlled trials.

Mark’s role is to provide health economics input to the programme, including trial-based economic evaluation of surgical trials in LMICs. One planned trial is looking at different methods to reduce surgical site infection (SSI). FALCON will be a factorial randomised control trial across three continents.

Previous Research

Mark’s previous research mainly involved undertaking economic evaluations using decision analytic modelling. He is experienced in building decision trees and Markov models (cohort & patient-level simulation).

Previous projects include Health Economic modelling with Dr Sue Jowett and colleagues in Birmingham and Oxford on a NIHR Programme Grant around Self-Monitoring in Hypertension.

He undertook a model-based economic analysis for the Telemonitoring and/or self-monitoring of blood pressure in hypertension (TASMINH4) trial.

Mark adapted a Markov cohort model used to inform the 2011 NICE hypertension guidelines to evaluate cost-effectiveness of a decision rule in the diagnosis of Hypertension. An article based on Society of Academic Primary Care (SAPC) conference abstract in July 2016 was published later that month on a GP news website: “Risk tool could help GPs pick up thousands more with hypertension

Mark has previously worked on an economic evaluation of clinical decision rules for restarting anticoagulants in unprovoked Venous thromboembolism (VTE) patients (NIHR HTA project number 10/94/02).

He has also worked with Dr Phil Kinghorn on the economics component of the PEGASUS trial (HTA project number 12/145/04). PEGASUS was a feasibility and open pilot two-arm RCT comparing Pressure Garment Therapy (PGT) with no-PGT in patients with burn injuries.

Mark’s first publication, assessing the costs and benefits of iodine supplementation tablets for UK pregnant women, garnered national and internal press coverage (e.g. The Times, New Scientist, BBC news). It is in the top 1% of all research output ever tracked by Altmetric (score of 143), an indicator of research impact.

He was an invited speaker to an All-Party Parliamentary Group, a cross-party group of MPs, in the Palace of Westminster (3rd July 2018).

Research Groups and Centres:


Gurung, B., Jackson, L.J., Monahan, M., Butterworth, R. and Roberts, T.E., 2018. Identifying and assessing the benefits of interventions for postnatal depression: a systematic review of economic evaluations. BMC pregnancy and childbirth, 18(1), p.179.

Moiemen N, Mathers J, Jones L, Bishop J, Kinghorn P, Monahan M, Calvert M, Slinn G, Gardiner F, Bamford A, Wright S, Litchfield I, Andrews N, Turner K, Grant M, Deeks J. A mixed methods feasibility study including a randomised trial of pressure garment therapy for the prevention of abnormal scarring after burn injury in adults and children (PEGASUS) .Health Technol Assess (Winchester, England)

McManus, R. J., Mant, J., Franssen, M., Nickless, A., Schwartz, C., Hodgkinson, J.,… Monahan M ... & Heneghan, C. (2018). Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial. The Lancet

Monahan, M., Jowett, S., Lovibond, K., Gill, P., Godwin, M., Greenfield, S., Hanley, J., Hobbs, F.R., Martin, U., Mant, J. and McKinstry, B., 2017. Predicting Out-of-Office Blood Pressure in the Clinic for the Diagnosis of Hypertension in Primary Care: An Economic Evaluation. Hypertension, HYPERTENSIONAHA.117.10244,

Pickering, K., Monahan, M., Guariglia, A. and Roberts, T.E., 2017. Time to tighten the belts? Exploring the relationship between savings and obesity. PloS one, 12(6), p.e0179921.

Franssen M, Farmer A, Grant S, et al. (2017) Telemonitoring and/or self-monitoring of blood pressure in hypertension (TASMINH4): protocol for a randomised controlled trial. BMC Cardiovasc Disord. 17: 58.

Monahan, M., Barton, P., Taylor, C.J., et al. (2017) MICE or NICE? An economic evaluation of clinical decision rules in the diagnosis of heart failure in primary care. International Journal of Cardiology.

Taylor CJ, Monahan M, Roalfe AK,et al (2017) The REFER (REFer for EchocaRdiogram) study: a prospective validation and health economic analysis of a clinical decision rule, NT-proBNP or their combination in the diagnosis of heart failure in primary care. Efficacy Mech Eval;4(3)

Sheppard J, Monahan M, Jowett S, et al. (2016) An economic evaluation of using a clinical decision rule (PROOF-BP algorithm) in the diagnosis of hypertension in primary care. European heart journal. Oxford Univ Press Great Clarendon St, Oxford OX2 6DP, England, 438-439.

Monahan M, Jowett S, Lovibond K, et al. (2016) An economic evaluation of using a clinical decision rule PRedicting Out-of-Office Blood Pressure (PROOF-BP) risk algorithm in the diagnosis of hypertension in primary care. Journal of Human Hypertension. Nature Publishing Group MacMillan Buidling, 4 Crinan St, London N1 9XW, England, 641-642.

Sharma V, Sudha S, Breheny K, et al. (2016) Methods used in Economic Evaluations of Testing and Diagnosis for Ovarian Cancer: a systematic review. International Journal of Gynecological Cancer ;26 (5), 865-872

Ensor J, Riley R, Jowett S, et al. (2016) Prediction of risk of recurrence of venous thromboembolism following treatment for a first unprovoked venous thromboembolism: systematic review, prognostic model and clinical decision rule, and economic evaluation. Health Technol Assess 20: 1.

Alam M, Barton P and Monahan M. (2015) Investigating The Impact of Structural Changes In A Nice Single Technology Appraisal Cost-Effectiveness Model. Value in health 18: A696-A696.

Monahan M, Boelaert K, Jolly K, et al. (2015) Costs and benefits of iodine supplementation for pregnant women in a mildly to moderately iodine-deficient population: a modelling analysis. The Lancet Diabetes & Endocrinology 3: 715-722.

View all publications in research portal