OHE has published a report detailing the views of a selection of experts in the fields of health and welfare economics on the cost-effectiveness threshold used by the National Institute for Health and Care Excellence (NICE) to decide which new medicines to recommend for use in the NHS, and the direction of future research in this area.
The study, written by OHE’s Sarah Karlsberg Schaffer, Patricia Cubi-Molla, Nancy Devlin and Adrian Towse, and commissioned by the Association of the British Pharmaceutical Industry (ABPI), involved individual interviews and a day-long workshop with 15 academic experts.
The objective of the research was to begin to shape a research agenda around future estimation and use of the threshold, and to explore how types of value other than quality-adjusted life years (QALYs) – the measure currently favoured by NICE – could be incorporated into the UK health technology assessment (HTA) process.
All study participants agreed that, given how critically important this topic is, it is necessary to improve the evidence base for NHS decisions regarding resource allocation and patients’ access to health care. There was a consensus view that there is no single best or correct approach to empirically estimating the threshold, and therefore, generating complementary evidence from a range of methods would be an appropriate way of informing the selection of thresholds for use in HTA decisions.
Participants generally agreed that the HTA process would benefit from a more transparent approach to decision making than is used currently, but there was no clear consensus regarding the use of multi-criteria decision analysis (MCDA) or indeed a more structured decision making framework as part of the process. In addition, it was argued that local prioritisation frameworks could be developed in order to strengthen commissioning and aid resource allocation decisions, particularly disinvestment decisions which were identified as a key challenge for the local NHS.
Following analysis and discussion of the information gathered during the interviews and the workshop, the report describes six potential directions for future research, including novel approaches to identifying the threshold and methods to test how more structured decision making could be used by NICE and other HTA bodies in practice.
To read the report please click here.
Posted in Health Technology Assessment, NICE, OHE Consulting, Risk-sharing Arrangements | Tagged Consulting Reports