Skip to main content
Erschienen in: PharmacoEconomics 7/2014

01.07.2014 | Editorial

NICE’s Cost-Effectiveness Range: Should it be Lowered?

verfasst von: J. P. Raftery

Erschienen in: PharmacoEconomics | Ausgabe 7/2014

Einloggen, um Zugang zu erhalten

Excerpt

This question goes to the heart of the use of the cost per quality-adjusted life-year (QALY) in healthcare decision making, notably by UK agencies, including the National Institute for Health and Care Excellence (NICE), the National Screening Committee and regarding immunisation, but with implications for other health systems that use the cost per QALY. NICE has indicated the range within which its threshold lies: £20k to £30k per QALY gained [1, 2]. The worry is that if these thresholds are too high, NICE’s recommendations could be doing more harm than good. This would happen when, say, recommending a drug on the basis of its incremental cost-effectiveness ratio (ICER) of £30k led other National Health Service (NHS) services with a low ICER being displaced. Do no harm (‘Non Nocere’) should apply to health economists as well as to doctors. …
Literatur
1.
Zurück zum Zitat NICE, Guide to the methods of technological appraisal. Ref: N1618; 2008. NICE, Guide to the methods of technological appraisal. Ref: N1618; 2008.
2.
Zurück zum Zitat NICE, Guide to the methods of technological appraisal. Ref: N0514; 2004. NICE, Guide to the methods of technological appraisal. Ref: N0514; 2004.
3.
Zurück zum Zitat Devlin N, Parkin N. Does NICE have an cost effectiveness threshold and what other factors influence its decisions? A binary choice analysis. Health Econ. 2004;13(5):437–52.PubMedCrossRef Devlin N, Parkin N. Does NICE have an cost effectiveness threshold and what other factors influence its decisions? A binary choice analysis. Health Econ. 2004;13(5):437–52.PubMedCrossRef
4.
Zurück zum Zitat Baker R, Bateman I, Donaldson C, Jones-Lee M, Lancsar E, Loomes G, Mason H, Odejar M, Pinto Prades JL, Robinson A, Ryan M, Shackley P, Smith R, Sugden R, Wildman J; the SVQ Research Team. Weighting and valuing quality-adjusted life-years using stated preference methods: preliminary results from the Social Value of a QALY Project. HTA J. 2010;14(27). http://www.hta.ac.uk/fullmono/mon1427.pdf. Baker R, Bateman I, Donaldson C, Jones-Lee M, Lancsar E, Loomes G, Mason H, Odejar M, Pinto Prades JL, Robinson A, Ryan M, Shackley P, Smith R, Sugden R, Wildman J; the SVQ Research Team. Weighting and valuing quality-adjusted life-years using stated preference methods: preliminary results from the Social Value of a QALY Project. HTA J. 2010;14(27). http://​www.​hta.​ac.​uk/​fullmono/​mon1427.​pdf.
5.
Zurück zum Zitat Martin S, Rice N, Smith PC. The link between health care spending and health outcomes in the new English primary care trusts. York: Centre for Health Economics; 2008. Martin S, Rice N, Smith PC. The link between health care spending and health outcomes in the new English primary care trusts. York: Centre for Health Economics; 2008.
6.
Zurück zum Zitat Martin S, Rice N, Smith P. Does health care spending improve health outcomes? J Health Econ. 2008;27:826–42.PubMedCrossRef Martin S, Rice N, Smith P. Does health care spending improve health outcomes? J Health Econ. 2008;27:826–42.PubMedCrossRef
7.
Zurück zum Zitat Martin S, Rice N, Smith P. Comparing costs and outcomes across programmes of health care. Health Econ. 2012;21:316–37.PubMedCrossRef Martin S, Rice N, Smith P. Comparing costs and outcomes across programmes of health care. Health Econ. 2012;21:316–37.PubMedCrossRef
8.
Zurück zum Zitat Claxton K, Martin S, Soares M, Rice N, Spackman E, Hinde S, Devlin N, Smith PC, Sculpher M. Methods for the estimation of the NICE cost effectiveness threshold final report. University of York CHE; 2013. Claxton K, Martin S, Soares M, Rice N, Spackman E, Hinde S, Devlin N, Smith PC, Sculpher M. Methods for the estimation of the NICE cost effectiveness threshold final report. University of York CHE; 2013.
9.
Zurück zum Zitat Barnsley P, Towse A, Karlberg S, Sussex J. Critique of CHE Research Paper 81: methods for the estimation of the NICE cost effectiveness threshold. OHE. Occasional Paper 13/01; 2013. Barnsley P, Towse A, Karlberg S, Sussex J. Critique of CHE Research Paper 81: methods for the estimation of the NICE cost effectiveness threshold. OHE. Occasional Paper 13/01; 2013.
12.
Zurück zum Zitat Latimere C. NICE’s end of life decision making scheme: impact on population health. BMJ. 2013;346:f1363. doi:10.1136/bmj.f1363 (Published 21 March 2013). Latimere C. NICE’s end of life decision making scheme: impact on population health. BMJ. 2013;346:f1363. doi:10.​1136/​bmj.​f1363 (Published 21 March 2013).
13.
Zurück zum Zitat Dakin H, Devlin N, Feng Y, Rice N, O’Neil P, Parkin D. The influence of cost effectiveness and other factors on NICE decisions. OHE Research Paper 13/06; 2013. Dakin H, Devlin N, Feng Y, Rice N, O’Neil P, Parkin D. The influence of cost effectiveness and other factors on NICE decisions. OHE Research Paper 13/06; 2013.
14.
Zurück zum Zitat Apleby J, Poteliakhoff E, Shah K, Devlin N. Using patient-reported outcome measures to estimate cost-effectiveness of hip replacements in English hospitals. J R Soc Med. 2013;106(8):323–31. doi:10.1177/0141076813489678.CrossRef Apleby J, Poteliakhoff E, Shah K, Devlin N. Using patient-reported outcome measures to estimate cost-effectiveness of hip replacements in English hospitals. J R Soc Med. 2013;106(8):323–31. doi:10.​1177/​0141076813489678​.CrossRef
16.
Zurück zum Zitat Coronini-Cronberg S, Appleby J, Thompson J. Application of patient-reported outcome measures (PROMs) data to estimate cost-effectiveness of hernia surgery in England. J R Soc Med. 2013;106:323–31.CrossRef Coronini-Cronberg S, Appleby J, Thompson J. Application of patient-reported outcome measures (PROMs) data to estimate cost-effectiveness of hernia surgery in England. J R Soc Med. 2013;106:323–31.CrossRef
17.
Zurück zum Zitat Michaels JA, et al. Randomised clinical trial, observational study and assessment of cost- effectiveness of the treatment of varicose veins (REACTIV Trial). Health Technol Assess. 2006;10(13):1–96.PubMed Michaels JA, et al. Randomised clinical trial, observational study and assessment of cost- effectiveness of the treatment of varicose veins (REACTIV Trial). Health Technol Assess. 2006;10(13):1–96.PubMed
18.
Zurück zum Zitat Street A, Gutacker N, Bojke C, Devlin N, Daidone S. Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data. Health Services Deliv Res. 2014;2(1), ISSN 2050-4349. doi:10.3310/hsdr02010. Street A, Gutacker N, Bojke C, Devlin N, Daidone S. Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data. Health Services Deliv Res. 2014;2(1), ISSN 2050-4349. doi:10.​3310/​hsdr02010.
19.
Zurück zum Zitat Eckermann S, Pekarsky B. Can the real opportunity cost stand up: displaced services, the straw man outside the room. Pharmacoeconomics 2014;32(4):319-25. Eckermann S, Pekarsky B. Can the real opportunity cost stand up: displaced services, the straw man outside the room. Pharmacoeconomics 2014;32(4):319-25.
20.
Zurück zum Zitat Paulden M, McCabe C, Karnon J. Achieving allocative efficiency in healthcare: nice in theory, not so NICE in practice? Pharmacoeconomics 2014;32(4):315-8. Paulden M, McCabe C, Karnon J. Achieving allocative efficiency in healthcare: nice in theory, not so NICE in practice? Pharmacoeconomics 2014;32(4):315-8.
Metadaten
Titel
NICE’s Cost-Effectiveness Range: Should it be Lowered?
verfasst von
J. P. Raftery
Publikationsdatum
01.07.2014
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 7/2014
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.1007/s40273-014-0158-6

Weitere Artikel der Ausgabe 7/2014

PharmacoEconomics 7/2014 Zur Ausgabe