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

Raftery, James

doi:10.1007/s40273-014-0158-6

Cited by 31 publications

(25 citation statements)

References 17 publications

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“…2). Although subject to debate (Raftery 2014), the National Institute for Health and Care Excellence currently uses a willingness-to-pay threshold of £20 000-£30 000 per QALY. The value attached to condition-specific measures, including in ADHD, is rarely explicit and is left to the decision maker.…”

Section: Main Findingsmentioning

confidence: 99%

Effectiveness and cost‐effectiveness of a brief school‐based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial

Sayal

Taylor

Valentine

et al. 2016

Child

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Section: Main Findingsmentioning

confidence: 99%

Effectiveness and cost‐effectiveness of a brief school‐based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial

Sayal

Taylor

Valentine

et al. 2016

Child

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“…Reimbursement varied significantly across Europe, with HTA bodies in England and Scotland recommending for reimbursement fewer than half of 44 indications approved by EMA, mostly owing to a lack of cost effectiveness. However, in several cases in England and Scotland indications that were not initially recommended for reimbursement were subsequently approved with risk-sharing agreements or patient access schemes, or were funded through the CDF [3, 36, 37]. Payers have responsibility for healthcare systems as a whole rather than just oncology, and may sometimes make difficult decisions to limit access to some agents in order to ensure the sustainability of the entire healthcare system.…”

Section: Resultsmentioning

confidence: 99%

Ethical Hurdles in the Prioritization of Oncology Care

Groot¹,

Capri

Castanier³

et al. 2016

Appl Health Econ Health Policy

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With finite resources, healthcare payers must make difficult choices regarding spending and the ethical distribution of funds. Here, we describe some of the ethical issues surrounding inequity in healthcare in nine major European countries, using cancer care as an example. To identify relevant studies, we conducted a systematic literature search. The results of the literature review suggest that although prevention, access to early diagnosis, and radiotherapy are key factors associated with good outcomes in oncology, public and political attention often focusses on the availability of pharmacological treatments. In some countries this focus may divert funding towards cancer drugs, for example through specific cancer drugs funds, leading to reduced expenditure on other areas of cancer care, including prevention, and potentially on other diseases. In addition, as highly effective, expensive agents are developed, the use of value-based approaches may lead to unacceptable impacts on health budgets, leading to a potential need to re-evaluate current cost-effectiveness thresholds. We anticipate that the question of how to fund new therapies equitably will become even more challenging in the future, with the advent of expensive, innovative, breakthrough treatments in other therapeutic areas.Electronic supplementary materialThe online version of this article (doi:10.1007/s40258-016-0288-4) contains supplementary material, which is available to authorized users.

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“…This paper presents a novel method to estimate the opportunity costs of care by combining mortality related outcomes and quality of life of patients into one outcome measure and relating it to changes in spending over time. To this aim, we built upon panel data methodology (Felder, 2006;Hall & Jones, 2004) and QALY estimation methods (Claxton et al, 2015a;Gheorghe et al, 2015), accounting for some of the issues raised in QALY threshold estimation (Barnsley, Towse, Karlsberg Schaffer, & Sussex, 2013;Raftery, 2014). Results indicate that in the Netherlands, at the margin, a QALY costs between €53.000 and €94.000 to produce, with a point estimate of €73.600.…”

Section: Discussionmentioning

confidence: 99%

The marginal benefits of healthcare spending in the Netherlands: Estimating cost‐effectiveness thresholds using a translog production function

Stadhouders

Koolman²,

Dijk

et al. 2019

Health Economics

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New technologies may displace existing, higher‐value care under a fixed budget. Countries aim to curtail adoption of low‐value technologies, for example, by installing cost‐effectiveness thresholds. Our objective is to estimate the opportunity cost of hospital care to identify a threshold value for the Netherlands. To this aim, we combine claims data, mortality data and quality of life questionnaires from 2012 to 2014 for 11,000 patient groups to obtain quality‐adjusted life‐year (QALY) outcomes and spending. Using a fixed effects translog model, we estimate that a 1% increase in hospital spending on average increases QALY outcomes by 0.2%. This implies a threshold of €73,600 per QALY, with 95% confidence intervals ranging from €53,000 to €94,000 per QALY. The results stipulate that new technologies with incremental cost effectiveness ratios exceeding the Dutch upper reference value of €80,000 may indeed displace more valuable care.

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

Cited by 31 publications

References 17 publications

Effectiveness and cost‐effectiveness of a brief school‐based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial

Effectiveness and cost‐effectiveness of a brief school‐based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial

Ethical Hurdles in the Prioritization of Oncology Care

The marginal benefits of healthcare spending in the Netherlands: Estimating cost‐effectiveness thresholds using a translog production function

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