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Causes For Concern: Is Nice Failing To Uphold Its Responsibilities To All Nhs Patients?

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  • Karl Claxton
  • Mark Sculpher
  • Stephen Palmer
  • Anthony J Culyer

Abstract

Organisations across diverse health care systems making decisions about the funding of new medical technologies face extensive stakeholder and political pressures. As a consequence, there is quite understandable pressure to take account of other attributes of benefit and to fund technologies, even when the opportunity costs are likely exceed the benefits they offer. Recent evidence suggests that NICE technology appraisal is already approving drugs where more health is likely to be lost than gained. Also, NICE recently proposed increasing the upper bound of the cost‐effectiveness threshold to reflect other attributes of benefit but without a proper assessment of the type of benefits that are expected to be displaced. It appears that NICE has taken a direction of travel, which means that more harm than good is being, and will continue to be, done, but it is unidentified NHS patients who bear the real opportunity costs. Copyright © 2014 John Wiley & Sons, Ltd.

Suggested Citation

  • Karl Claxton & Mark Sculpher & Stephen Palmer & Anthony J Culyer, 2015. "Causes For Concern: Is Nice Failing To Uphold Its Responsibilities To All Nhs Patients?," Health Economics, John Wiley & Sons, Ltd., vol. 24(1), pages 1-7, January.
    • Handle: RePEc:wly:hlthec:v:24:y:2015:i:1:p:1-7
    DOI: 10.1002/hec.3130
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    References listed on IDEAS

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    1. Karl Claxton & Simon Walker & Steven Palmer & Mark Sculpher, 2010. "Appropriate Perspectives for Health Care Decisions," Working Papers 054cherp, Centre for Health Economics, University of York.
    2. Karl Claxton & Mark Sculpher & Stuart Carroll, 2011. "Value-based pricing for pharmaceuticals: Its role, specification and prospects in a newly devolved NHS," Working Papers 060cherp, Centre for Health Economics, University of York.
    3. David Meltzer, 1997. "Accounting for Future Costs in Medical Cost-Effectiveness Analysis," NBER Working Papers 5946, National Bureau of Economic Research, Inc.
    4. Meltzer, David, 1997. "Accounting for future costs in medical cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 33-64, February.
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    1. Elamin Elbasha & Jagpreet Chhatwal, 2016. "Myths and Misconceptions of Within-Cycle Correction: A Guide for Modelers and Decision Makers," PharmacoEconomics, Springer, vol. 34(1), pages 13-22, January.
    2. Claxton, Karl & Asaria, Miqdad & Chansa, Collins & Jamison, Julian & Lomas, James & Ochalek, Jessica & Paulden, Mike, 2019. "Accounting for timing when assessing health-related policies," LSE Research Online Documents on Economics 100038, London School of Economics and Political Science, LSE Library.
    3. Nadia Pillai & Mark Dusheiko & Bernard Burnand & Valérie Pittet, 2017. "A systematic review of cost-effectiveness studies comparing conventional, biological and surgical interventions for inflammatory bowel disease," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-22, October.
    4. Culyer, Anthony J., 2016. "Cost-effectiveness thresholds in health care: a bookshelf guide to their meaning and use," Health Economics, Policy and Law, Cambridge University Press, vol. 11(4), pages 415-432, October.
    5. Matthew Franklin & Sebastian Hinde & Rachael Maree Hunter & Gerry Richardson & William Whittaker, 2024. "Is Economic Evaluation and Care Commissioning Focused on Achieving the Same Outcomes? Resource-Allocation Considerations and Challenges Using England as a Case Study," Applied Health Economics and Health Policy, Springer, vol. 22(4), pages 435-445, July.
    6. Freekje van Asten & Charlotte T J Michels & Carel B Hoyng & Gert Jan van der Wilt & B Jeroen Klevering & Maroeska M Rovers & Janneke P C Grutters, 2018. "The cost-effectiveness of bevacizumab, ranibizumab and aflibercept for the treatment of age-related macular degeneration—A cost-effectiveness analysis from a societal perspective," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-14, May.
    7. Martin, Stephen & Claxton, Karl & Lomas, James & Longo, Francesco, 2023. "The impact of different types of NHS expenditure on health: Marginal cost per QALY estimates for England for 2016/17," Health Policy, Elsevier, vol. 132(C).
    8. Jessica Ochalek & James Lomas & Karl Claxton, 2015. "Cost per DALY averted thresholds for low- and middle-income countries: evidence from cross country data," Working Papers 122cherp, Centre for Health Economics, University of York.
    9. Matthew Franklin & Colin Angus & Tobias Welte & Guy Joos, 2023. "How Much Should be Invested in Lung Care Across the WHO European Region? Applying a Monetary Value to Disability-Adjusted Life-Years Within the International Respiratory Coalition’s Lung Facts," Applied Health Economics and Health Policy, Springer, vol. 21(4), pages 547-558, July.
    10. Huang, Li & Frijters, Paul & Dalziel, Kim & Clarke, Philip, 2018. "Life satisfaction, QALYs, and the monetary value of health," Social Science & Medicine, Elsevier, vol. 211(C), pages 131-136.
    11. Elamin H. Elbasha & Jagpreet Chhatwal, 2016. "Myths and Misconceptions of Within-Cycle Correction: A Guide for Modelers and Decision Makers," PharmacoEconomics, Springer, vol. 34(1), pages 13-22, January.
    12. James Lomas & Jessica Ochalek & Rita Faria, 2022. "Avoiding Opportunity Cost Neglect in Cost-Effectiveness Analysis for Health Technology Assessment," Applied Health Economics and Health Policy, Springer, vol. 20(1), pages 13-18, January.
    13. Alec Morton & Amanda I. Adler & David Bell & Andrew Briggs & Werner Brouwer & Karl Claxton & Neil Craig & Alastair Fischer & Peter McGregor & Pieter van Baal, 2016. "Unrelated Future Costs and Unrelated Future Benefits: Reflections on NICE Guide to the Methods of Technology Appraisal," Health Economics, John Wiley & Sons, Ltd., vol. 25(8), pages 933-938, August.
    14. Øystein Ariansen Haaland & Frode Lindemark & Kjell Arne Johansson, 2019. "A flexible formula for incorporating distributive concerns into cost-effectiveness analyses: Priority weights," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-12, October.
    15. Jessica Ochalek & Karl Claxton & Paul Revill & Mark Sculpher & Alexandra Rollinger, 2016. "Supporting the development of an essential health package: principles and initial assessment for Malawi," Working Papers 136cherp, Centre for Health Economics, University of York.
    16. Pieter Baal & Alec Morton & David Meltzer & Werner Brouwer, 2019. "Future unrelated medical costs need to be considered in cost effectiveness analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 1-5, February.
    17. Claxton, Karl & Asaria, Miqdad & Chansa, Collins & Jamison, Julian & Lomas, James & Ochalek, Jessica & Paulden, Mike, 2019. "Accounting for Timing when Assessing Health-Related Policies," Journal of Benefit-Cost Analysis, Cambridge University Press, vol. 10(S1), pages 73-105, April.
    18. James Love-Koh & Richard Cookson & Karl Claxton & Susan Griffin, 2020. "Estimating Social Variation in the Health Effects of Changes in Health Care Expenditure," Medical Decision Making, , vol. 40(2), pages 170-182, February.
    19. Jessica Ochalek & Miqdad Asaria & Pei Fen Chuar & James Lomas & Sumit Mazumdar & Karl Claxton, 2019. "Assessing health opportunity costs for the Indian health care systems," Working Papers 161cherp, Centre for Health Economics, University of York.
    20. Praveen Thokala & Jessica Ochalek & Ashley A. Leech & Thaison Tong, 2018. "Cost-Effectiveness Thresholds: the Past, the Present and the Future," PharmacoEconomics, Springer, vol. 36(5), pages 509-522, May.
    21. Beth Woods & James Lomas & Mark Sculpher & Helen Weatherly & Karl Claxton, 2024. "Achieving dynamic efficiency in pharmaceutical innovation: Identifying the optimal share of value and payments required," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 804-819, April.
    22. Christopher McCabe, 2019. "Expanding the Scope of Costs and Benefits for Economic Evaluations in Health: Some Words of Caution," PharmacoEconomics, Springer, vol. 37(4), pages 457-460, April.
    23. Lucarelli, Claudio & Nicholson, Sean & Tilipman, Nicholas, 2022. "Price Indices and the Value of Innovation with Heterogenous Patients," Journal of Health Economics, Elsevier, vol. 84(C).
    24. Pieter van Baal & Meg Perry‐Duxbury & Pieter Bakx & Matthijs Versteegh & Eddy van Doorslaer & Werner Brouwer, 2019. "A cost‐effectiveness threshold based on the marginal returns of cardiovascular hospital spending," Health Economics, John Wiley & Sons, Ltd., vol. 28(1), pages 87-100, January.

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