UPDATE TO THE NICE TECHNOLOGY APPRAISALS METHODS GUIDE (2013)
NICE has published the update to the Guide to the Methods of Technology Appraisal.
The following briefing papers and reports, which have contributed to the process, were initiated by NICE and co-authored/reviewed in many instances by the DSU.
The key changes are as follows:
- Patient evidence – the section in ‘involvement and participation’ has been revised to clarify the type of information required from patient organisations and the role of qualitative research
- Choice of comparators – the scoping section of the guide has been changed to reflect the fact that the selection of the final comparator(s) to be used for decision making ultimately lies with the Appraisal Committee and so no potentially relevant comparators should be eliminated at the scoping stage
- Equity position for quality adjusted life years (QALYs)- for the reference case the equity position remains that all quality adjusted life years (QALYs) carry equal weight
- Use of structured decision making techniques – the guide directs the Appraisal Committee to take a deliberative approach when considering the extent to which society may be prepared to forego health gain in order to achieve non-health related benefits delivered by health technologies.
- Discounting -the reference case discount rate remains 3.5% for both costs and health effects. The updated guide notes that the Appraisal Committee may consider a lower discount rate of 1.5% for costs and health effects in certain circumstances.
- Perspective – the reference case perspective remains unchanged, that is NHS and personal social services with the possibility of broadening it to consideration of costs and benefits to other government bodies after agreement with the Department of Health.
- Measuring and valuing health effects – the guide provides additional detail on the circumstances in which the EQ-5D instrument may not be appropriate and provides information on what to do if appropriate generic health related quality of life data has not been collected in the clinical trials.
- Research recommendations – the guide includes further detail on the factors the Appraisal Committee will consider before making a recommendation that technology is used only in the context of research or while the technology is recommended as an option, research is also conducted.
- Miners, A.(2008) Estimating ‘costs’ for cost-effectiveness analysis. Pharmacoeconomics Vol:26(9):745-751
- Sutton, A.,Ades, AE.,Cooper, N.,Abrams, K.(2008) Use of indirect and mixed treatment comparisons for technology assessment. Pharmacoeconomics Vol:26 (9): 753-767
- Sculpher, M.(2008) Subgroups and heterogeneity in cost-effectiveness analysis. Pharmacoeconomics Vol: 26 (9): 799-806
- McCabe,C.,Claxton,K.,Culyer, AJ.(2008) The NICE cost-effectiveness threshold. What it is and what that means. Pharmacoeconomics Vol: 26 (9): 733-744
- Claxton, K.(2008) Exploring uncertainty in cost-effectiveness analysis. Pharmacoeconomics Vol: 26: 781-798
- Brazier, J.(2008) Valuing health states for use in cost-effectiveness analysis. Pharmacoeconomics Vol: 26 (9): 769-779