Match!

Methods for the Estimation of the NICE Cost Effectiveness Threshold

Published on Feb 1, 2015in Health Technology Assessment3.819
· DOI :10.3310/hta19140
Karl Claxton53
Estimated H-index: 53
(Ebor: University of York),
Stephen Martin22
Estimated H-index: 22
(Ebor: University of York)
+ 6 AuthorsMark Sculpher75
Estimated H-index: 75
(Ebor: University of York)
Sources
Abstract
A study by health economists at the University of York has, for the first time, produced an estimate of the impact on other NHS patients of new and more costly drugs and other treatments. This research suggests a refinement of the way the National Institute for Health and Clinical Excellence (NICE) gauges the cost-effectiveness of new interventions. It also has implications for the prices that the NHS can afford to pay for new drugs when the value-based pricing scheme for all new drugs is introduced by the Government in 2014.
  • References (140)
  • Citations (346)
📖 Papers frequently viewed together
1987
9,698 Citations
433 Citations
759 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References140
Newest
#1Karl ClaxtonH-Index: 53
#2Stephen PalmerH-Index: 49
Last. Ji-Hee YounH-Index: 4
view all 9 authors...
© Queen’s Printer and Controller of HMSO 2012. This work was produced by Claxton et al. under the terms of a commissioning contract issued by the Secretary of State for Health.
76 CitationsSource
#1John A. Vernon (UNC: University of North Carolina at Chapel Hill)H-Index: 11
#2Robert Goldberg (Center for Medicine in the Public Interest)H-Index: 5
Last. Joseph H. Golec (UConn: University of Connecticut)H-Index: 17
view all 3 authors...
In this article we describe how reimbursement cost-effectiveness thresholds, per unit of health benefit, whether set explicitly or observed implicitly via historical reimbursement decisions, serve as a signal to firms about the commercial viability of their R&D projects (including candidate products for in-licensing). Traditional finance methods for R&D project valuations, such as net present value analyses (NPV), incorporate information from these payer reimbursement signals to help determine w...
11 CitationsSource
#1Stephen Martin (Ebor: University of York)H-Index: 22
#2Nigel Rice (Ebor: University of York)H-Index: 36
Last. Peter C. Smith (Imperial College London)H-Index: 58
view all 3 authors...
: This paper examines the expenditure choices of local health authorities operating under fixed budget constraints. It applies a theoretical model of budgeting to a data set from 303 English Primary Care Trusts (PCTs) across ten broad programmes of health care to derive estimates of the elasticity of expenditure in each programme with respect to the total income of the PCT. The results suggest quite similar income elasticities across most programmes, in the range 0.644-1.128. The only outlier is...
18 CitationsSource
Art therapy as currently offered in the UK is not effective Schizophrenia is the most common psychotic disorder and the most pervasive. It is characterised by “positive” symptoms, such as hallucinations and delusions, and “negative” symptoms, such as apathy and social withdrawal. Negative symptoms contribute greatly to the functional impairment and poor psychosocial outcomes in schizophrenia. Advances in the management of schizophrenia in the past 60 years have included drug treatments, psychoso...
9 CitationsSource
#1Mike J. Crawford (Imperial College London)H-Index: 42
#2Helen Killaspy (UCL: University College London)H-Index: 25
Last. Diane Waller (Imperial College London)H-Index: 3
view all 20 authors...
Objectives To evaluate the clinical effectiveness of group art therapy for people with schizophrenia and to test whether any benefits exceed those of an active control treatment.
151 CitationsSource
#1Jennifer Dixon (Nuffield Trust)H-Index: 23
#2Peter C. Smith (Imperial College London)H-Index: 58
Last. Colin Sanderson (Lond: University of London)H-Index: 30
view all 11 authors...
Objectives To develop a formula for allocating resources for commissioning hospital care to all general practices in England based on the health needs of the people registered in each practice Design Multivariate prospective statistical models were developed in which routinely collected electronic information from 2005-6 and 2006-7 on individuals and the areas in which they lived was used to predict their costs of hospital care in the next year, 2007-8. Data on individuals included all diagnoses...
58 CitationsSource
#1Nils Gutacker (Ebor: University of York)H-Index: 11
#2Chris Bojke (Ebor: University of York)H-Index: 14
Last. Andrew Street (Ebor: University of York)H-Index: 29
view all 6 authors...
Accounting for variation in the quality of care is a major challenge for the assessment of hospital cost performance. Because data on patients’ health improvement are generally not available, existing studies have resorted to inherently incomplete outcome measures such as mortality or re-admission rates. This opens up the possibility that providers of high quality care are falsely deemed inefficient and vice versa. This study makes use of a novel dataset of routinely collected patient-reported o...
34 CitationsSource
#1Marta Soares (Ebor: University of York)H-Index: 22
#2Laura Bojke (Ebor: University of York)H-Index: 21
Last. Karl Claxton (Ebor: University of York)H-Index: 53
view all 6 authors...
We can use decision models to estimate cost effectiveness, quantify uncertainty regarding the adoption decision and provide estimates of the value of further research. In many cases, the existence of only limited data with which to populate a decision model can mean that a cost-effectiveness analysis either does not proceed or may misrepresent the degree of uncertainty associated with model inputs. An example is the case of negative pressure wound therapy (NPWT) used to treat severe pressure ulc...
35 CitationsSource
#1Christopher H. Jackson (Ebor: University of York)H-Index: 20
#2Laura Bojke (Ebor: University of York)H-Index: 21
Last. Linda D. Sharples (Ebor: University of York)H-Index: 53
view all 5 authors...
Decision analytic models used for health technology assessment are subject to uncertainties. These uncertainties can be quantified probabilistically, by placing distributions on model parameters and simulating from these to generate estimates of cost-effectiveness. However, many uncertain model choices, often termed structural assumptions, are usually only explored informally by presenting estimates of cost-effectiveness under alternative scenarios. The authors show how 2 recent research proposa...
53 CitationsSource
#1Karl Claxton (Ebor: University of York)H-Index: 53
#2Mike Paulden (Ebor: University of York)H-Index: 18
Last. Anthony J. Culyer (Ebor: University of York)H-Index: 41
view all 5 authors...
Discounting costs and health benefits in cost-effectiveness analysis has been the subject of recent debate – some authors suggesting a common rate for both and others suggesting a lower rate for health. We show how these views turn on key judgments of fact and value: on whether the social objective is to maximise discounted health outcomes or the present consumption value of health; on whether the budget for health care is fixed; on the expected growth in the cost‐effectiveness threshold; and on...
127 CitationsSource
Cited By346
Newest
Source
#1Stephanie Annett (University of Medicine and Health Sciences)
In 2019, the record for the most expensive drug was broken at US$2.1 million per patient. The high costs of new drugs are justified by the pharmaceutical industry as the expense required for maintaining research and development (RD first through R&D, and then paying the high prices upon approval. High drug prices distort research priorities, emphasising financial gains and not health gains. In this manuscript, issues surrounding the current patent-based drug development model, public funding of ...
Source
#1Jonathan Cylus (European Observatory on Health Systems and Policies)H-Index: 19
#2Peter C. Smith (Imperial College London)H-Index: 60
Jonathan Cylus and Peter Smith consider how measurement of wellbeing might be used to set public sector priorities
Source
#1Edward BurnH-Index: 8
Last. Rafael Pinedo-VillanuevaH-Index: 8
view all 6 authors...
Abstract Objectives To estimate threshold prices for computer- and robot-assisted knee and hip replacement. Methods A lifetime cohort Markov model provided the framework for analysis. Linked primary care and inpatient hospital records informed estimates of outcomes under current practice. Outcomes were estimated under a range of hypothetical relative improvements in quality of life if unrevised and in revision risk after computer or robot-assisted surgery. Threshold prices, a price at which the ...
Source
#1Sebastian Hinde (Ebor: University of York)H-Index: 7
Last. Gerald Richardson (Ebor: University of York)H-Index: 32
view all 4 authors...
Since 2013, obesity services in the UK National Health Service (NHS) have focused on a tiered structure, with tiers 3 (specialist weight management services) and 4 (primarily bariatric surgery) commissioned by Clinical Commissioning Groups (CCGs) and widely reported as cost effective and recommended by national guidelines. However, CCGs have been reluctant to fully conform to the guidance. We explore how the different evaluative perspective of those generating evidence from local decision makers...
Source
#1Ijeoma Edoka (University of the Witwatersrand)H-Index: 4
#2Nicholas Stacey (University of the Witwatersrand)H-Index: 2
Cost-effectiveness thresholds are important decision rules that determine whether health interventions represent good value for money. In low- and middle-income countries, the World Health Organization (WHO) one to three times per capita gross domestic product (GDP) per disability-adjusted life years (DALYs) averted has been the most widely used threshold for informing resource allocation decisions. However, in 2016, the WHO withdrew recommendations for using this threshold, creating a significa...
Source
#1Maria BalchH-Index: 2
#2Shahid M. NimjeeH-Index: 19
view all 4 authors...
Source
#1B Tehard (Hoffmann-La Roche)H-Index: 1
#2B. DetournayH-Index: 7
Last. Gérard de Pouvourville (ESSEC Business School)H-Index: 21
view all 5 authors...
Abstract Objective France has included health economic assessment (HEA) as an official criterion for innovative drug pricing since 2013. Until now, no cost-effectiveness threshold (CET) has been officially proposed to qualify incremental cost-effectiveness ratios (ICERs). Although the French health authorities have publicly expressed the need for such reference values, previous initiatives to determine these have failed. The study aims to propose a locally adapted method for estimating a prefere...
Source
The rapid development in healthcare technologies in recent years has resulted in the need for health services, whether publicly funded or insurance based, to identify means to maximise the benefits and provide equitable distribution of limited resources. This has resulted in the need for rationing decisions, and there has been considerable debate regarding the substantive and procedural ethical principles that promote distributive justice when making such decisions. In this paper, I argue that w...
Source
Zusammenfassung Hintergrund Entscheidungen zur Kostenubernahme (Erstattungsentscheidungen) sind Entscheidungen von Drittzahlern daruber, ob, in welcher Hohe und unter welchen Bedingungen Kosten fur Technologien oder Dienstleistungen ubernommen werden. Aufgrund der Komplexitat solcher Entscheidungen ist hierbei eine systematische und transparente Herangehensweise erforderlich. Im Rahmen des DECIDE-Projekts (DECIDE: Developing and Evaluating Communication Strategies to Support Informed Decisions a...
Source