GUPEA

Gothenburg University Publications Electronic Archive

GUPEA is a platform for e-publishing of theses, student essays and other research publications.

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Recent Submissions

  • Health Economic Aspects of Cancer Care: Evaluating Evidence for Drug Reimbursement and Screening Programs
    (2026-01-15) Chauca Strand, Gabriella
    To improve population health and ensure value for money, decision-making in health care must rely on transparent and well-informed evaluations of the expected costs and effects of new health interventions. The purpose of this thesis was to generate and evaluate evidence on the clinical effectiveness and cost-effectiveness of interventions introduced within the cancer care pathway to inform future policy discussions and decision-making. The thesis focuses on two areas: reimbursement decisions for cancer drugs and colorectal cancer (CRC) screening in Sweden, using descriptive analysis, econometrics, and health economic modeling. Papers I–II assessed the evidence on clinical effectiveness and cost-effectiveness underlying reimbursement decisions for new prescription cancer drugs, using public decision dossiers and published literature. The findings show that a considerable proportion of reimbursement decisions rely on inconclusive evidence regarding improvements in overall survival (OS) and quality of life (QoL). Paper III–IV evaluated the effectiveness, cost-effectiveness, and inequality impact of organized CRC screening programs in reducing incidence and improving quality-adjusted life years, using secondary literature and registry data. The results indicate that CRC screening effectively improves health outcomes and is cost-effective; however, the benefits are unevenly distributed across socioeconomic groups. In conclusion, the thesis findings imply uncertainty regarding cancer drugs’ value for money and the benefits ultimately realized by patients and society. Furthermore, organized CRC screening reduces disease burden and improves population health; yet it may exacerbate existing socioeconomic inequalities in health.
  • En legitim tronarvinge? Kvinnlig tronföljd, möderne och äkta börd i Norge, 1161–1302
    (2026-01-15) Husvik, Benjamin
    This doctoral thesis concerns the development of female succession in Norway from 1161–1302 in relation to the broader European context. The rationale behind this thesis is twofold. First, structural factors have, in general, been neglected in previous research on the implementation of female succession in Norway in 1302. Second, the development of female succession in Norway has not been examined in relation to the broader European setting. Situating the Norwegian development in a wider European context can help illuminate the role of structural factors in the implementation of female succession in Norway. The investigation of the Norwegian case can also highlight similarities and differences between Norway and Europe with regards to the development of female succession and queenship. The bulk of the thesis focuses on how and why structural factors, particularly legitimate birth and maternal descent, changed in Norway and made the ratification of female succession possible. Focus is specifically put on what value legitimate birth and maternal descent was ascribed as symbolic capital for making claims to the Norwegian throne and how political actors (il)legitimation activities, for example in their power struggles for the throne, altered this value. The consequences of the implementation of female succession for the power of royal women are also examined, particularly whether any potential heiresses could become recognized as a queen regnant. One of the main conclusions reached in the thesis is that changes to structural factors, such as maternal descent, played a crucial role in the implementation of female succession in Norway. This finding is in sharp contrast to previous research, which was mainly concerned with the explanatory power of situational factors in the development, especially that the reigning king Haakon Magnusson lacked male children. Also, this thesis demonstrates that under normal circumstances, Norwegian heiresses would not be recognized as a queen regnant, with the caveat that some potential existed for widows to become female monarchs. This result corresponds with international research about queenship but contrasts with previous research about Norway.
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