NICE’s cost-effectiveness threshold
|Consortium of 13 British pharmaceutical companies
|Nancy Devlin, Office of Health Economics; David Parkin, NHS South-East Coast; Nigel Rice, University of York
Analysis of NICE’s cost-effectiveness threshold and criteria influencing NICE decisions
Since its establishment in 1999, the National Institute of Health and Clinical Excellence (NICE) has been using evidence on cost-effectiveness and other factors to make judgements about which treatments represent good value for money and which should be made available on the NHS.
NICE has stated that it “should explain its reasons when it decides that an intervention with an ICER below £20,000 per QALY gained is not cost effective; and when an intervention with an ICER of more than £20,000 to £30,000 per QALY gained is cost effective” and has emphasised that cost-effectiveness is not the only thing taken into account in its decision-making (NICE, 2008). However, it is unclear which other criteria it does take into account or what trade-offs it is prepared to make between these factors and cost-effectiveness.
We are therefore using data on the decisions that NICE has been observed to make, and the evidence it considered when making those decisions to reveal NICE’s preferences. Econometric techniques will be used to identify what cost-effectiveness threshold NICE use in practice and which other factors systematically affect its decisions.
This research builds on and extends the modelling approach reported by Devlin and Parkin (2004) and by Dakin et al (2006) and uses the data from the HTA inSite database.
A research paper presenting final results is now available.
Results of interim analyses on a preliminary dataset were presented at: the 8th European Conference on Health Economics in Helsinki, Finland in July 2010; the ISPOR 13th Annual European Congress in Prague, Czech Republic in November 2010; and the Health Economists' Study Group (HESG) meeting in York in January 2011.
Dakin, H, Devlin, N, Feng, Y, Rice, N, O'Neill, P, and Parkin, D (2014). The influence of cost-effectiveness and other factors on NICE decisions. Health Econ, doi: 10.1002/hec.3086 [Epub ahead of print].