IDEAS home Printed from https://ideas.repec.org/p/pra/mprapa/29772.html
   My bibliography  Save this paper

Does the National Institute for Health and Clinical Excellence take account of factors such as uncertainty and equity as well as incremental cost-effectiveness in commissioning health care services? A binary choice experiment

Author

Listed:
  • Tappenden, P
  • Brazier, J
  • Ratcliffe, J

Abstract

Background NICE is an independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health in England and Wales. One of NICE’s main roles is to produce national guidance on the use of health technologies within the NHS. Despite the Institute’s recent efforts to clarify the way in which its Appraisal Committees reach their recommendations concerning the use of health technologies, there remains ambiguity about how cost-effectiveness evidence is interpreted alongside other considerations such as the degree of clinical need within the patient population, and the degree of uncertainty surrounding cost-effectiveness estimates. Objective To explore whether the NICE takes account of factors such as uncertainty and equity as well as incremental cost-effectiveness in commissioning health care services. Methods A binary choice experiment was undertaken using NICE’s three Appraisal Committees. The experiment included five attributes: (1) Incremental cost-effectiveness (2) Degree of economic uncertainty (3) Age of the target population (4) Baseline health-related quality of life (5) Availability of other therapies A choice questionnaire detailing 18 scenarios was administered to NICE’s Appraisal Committees. For each scenario, respondents were asked to indicate whether they would recommend the intervention under consideration or not. The stated preference data obtained from respondents were analysed using a random effects logit regression model. Results A response rate of 46% was obtained from the Appraisal Committees. The regression model suggests that increases in cost-effectiveness, economic uncertainty, and the availability of other therapies are associated with statistically significant reductions in the odds of adoption (p

Suggested Citation

  • Tappenden, P & Brazier, J & Ratcliffe, J, 2006. "Does the National Institute for Health and Clinical Excellence take account of factors such as uncertainty and equity as well as incremental cost-effectiveness in commissioning health care services? A," MPRA Paper 29772, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:29772
    as

    Download full text from publisher

    File URL: https://mpra.ub.uni-muenchen.de/29772/1/MPRA_paper_29772.pdf
    File Function: original version
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Yoo, Dong-il & Ohta, Hiroshi, 1995. "Optimal pricing and product-planning for new multiattribute products based on conjoint analysis," International Journal of Production Economics, Elsevier, vol. 38(2-3), pages 245-253, March.
    2. Magat, Wesley A. & Kip Viscusi, W. & Huber, Joel, 1988. "Paired comparison and contingent valuation approaches to morbidity risk valuation," Journal of Environmental Economics and Management, Elsevier, vol. 15(4), pages 395-411, December.
    3. Stephen Birch & Amiram Gafni, 2002. "On being NICE in the UK: guidelines for technology appraisal for the NHS in England and Wales," Health Economics, John Wiley & Sons, Ltd., vol. 11(3), pages 185-191, April.
    4. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208, February.
    5. Victor R. Fuchs, 1998. "Who Shall Live?," World Scientific Book Chapters, in: Who Shall Live? Health, Economics, and Social Choice, chapter 3, pages 30-55, World Scientific Publishing Co. Pte. Ltd..
    6. Propper, Carol, 1990. "Contingent Valuation of Time Spent on NHS Waiting Lists," Economic Journal, Royal Economic Society, vol. 100(400), pages 193-199, Supplemen.
    7. John Hutton & Alan Maynard, 2000. "A nice challenge for health economics," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 89-93, March.
    8. Ryan, Mandy, 1999. "Using conjoint analysis to take account of patient preferences and go beyond health outcomes: an application to in vitro fertilisation," Social Science & Medicine, Elsevier, vol. 48(4), pages 535-546, February.
    9. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304, October.
    10. Mandy Ryan, 1996. "Using Consumer Preferences in Health Care Decision Making: The Application of Conjoint Analysis," Monograph 000420, Office of Health Economics.
    11. Dolan, Paul & Olsen, Jan Abel, 2002. "Distributing Health Care: Economic and ethical issues," OUP Catalogue, Oxford University Press, number 9780192632531.
    12. Nancy Devlin & David Parkin, 2004. "Does NICE have a cost‐effectiveness threshold and what other factors influence its decisions? A binary choice analysis," Health Economics, John Wiley & Sons, Ltd., vol. 13(5), pages 437-452, May.
    13. Alan Williams, 2004. "What Could be Nicer than NICE?," Monograph 000489, Office of Health Economics.
    14. Drummond, Michael & Torrance, George & Mason, James, 1993. "Cost-effectiveness league tables: More harm than good?," Social Science & Medicine, Elsevier, vol. 37(1), pages 33-40, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Katerina Paclikova & Zuzana Dankulincova Veselska & Daniela Filakovska Bobakova & Michaela Palfiova & Andrea Madarasova Geckova, 2019. "What role do family composition and functioning play in emotional and behavioural problems among adolescent boys and girls?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(2), pages 209-217, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Colin Green & Karen Gerard, 2009. "Exploring the social value of health‐care interventions: a stated preference discrete choice experiment," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 951-976, August.
    2. Richard T. Carson, 2011. "Contingent Valuation," Books, Edward Elgar Publishing, number 2489.
    3. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    4. Gafni, Amiram & Birch, Stephen, 2006. "Incremental cost-effectiveness ratios (ICERs): The silence of the lambda," Social Science & Medicine, Elsevier, vol. 62(9), pages 2091-2100, May.
    5. Karen Gerard & Marian Shanahan & Jordan Louviere, 2003. "Using stated preference discrete choice modelling to inform health care decision-making: A pilot study of breast screening participation," Applied Economics, Taylor & Francis Journals, vol. 35(9), pages 1073-1085.
    6. Emily Lancsar & Jordan Louviere, 2008. "Conducting Discrete Choice Experiments to Inform Healthcare Decision Making," PharmacoEconomics, Springer, vol. 26(8), pages 661-677, August.
    7. Lancsar, Emily & Louviere, Jordan & Flynn, Terry, 2007. "Several methods to investigate relative attribute impact in stated preference experiments," Social Science & Medicine, Elsevier, vol. 64(8), pages 1738-1753, April.
    8. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    9. José Miguel Sánchez U., 2013. "Contingent valuation and choice experiments applied to the Sierra Nevada National Park in Venezuela," Economía, Instituto de Investigaciones Económicas y Sociales (IIES). Facultad de Ciencias Económicas y Sociales. Universidad de Los Andes. Mérida, Venezuela, vol. 38(35), pages 57-100, January-J.
    10. Emma McIntosh, 2006. "Using Discrete Choice Experiments within a Cost-Benefit Analysis Framework," PharmacoEconomics, Springer, vol. 24(9), pages 855-868, September.
    11. John Hutton, 2012. "‘Health Economics’ and the evolution of economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 21(1), pages 13-18, January.
    12. Appleby, John & Devlin, Nancy & Parkin, David & Buxton, Martin & Chalkidou, Kalipso, 2009. "Searching for cost effectiveness thresholds in the NHS," Health Policy, Elsevier, vol. 91(3), pages 239-245, August.
    13. Mandy Ryan & Angela Bate, 2001. "Testing the assumptions of rationality, continuity and symmetry when applying discrete choice experiments in health care," Applied Economics Letters, Taylor & Francis Journals, vol. 8(1), pages 59-63.
    14. Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2015. "Valuing health at the end of life: A stated preference discrete choice experiment," Social Science & Medicine, Elsevier, vol. 124(C), pages 48-56.
    15. Emily Lancsar & Elizabeth Savage, 2004. "Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 901-907, September.
    16. Jonathan E. Alevy & John A. List & Wiktor L. Adamowicz, 2011. "How Can Behavioral Economics Inform Nonmarket Valuation? An Example from the Preference Reversal Literature," Land Economics, University of Wisconsin Press, vol. 87(3), pages 365-381.
    17. Andrew M. Jones (ed.), 2012. "The Elgar Companion to Health Economics, Second Edition," Books, Edward Elgar Publishing, number 14021.
    18. Jeannette Winkelhage & Adele Diederich, 2012. "The Relevance of Personal Characteristics in Allocating Health Care Resources—Controversial Preferences of Laypersons with Different Educational Backgrounds," IJERPH, MDPI, vol. 9(1), pages 1-21, January.
    19. Emily Lancsar, 2002. "Deriving welfare measures from stated preference discrete choice modelling experiments, CHERE Discussion Paper No 48," Discussion Papers 48, CHERE, University of Technology, Sydney.
    20. Fawsitt, Christopher G. & Bourke, Jane & Greene, Richard A. & McElroy, Brendan & Krucien, Nicolas & Murphy, Rosemary & Lutomski, Jennifer E., 2017. "What do women want? Valuing women’s preferences and estimating demand for alternative models of maternity care using a discrete choice experiment," Health Policy, Elsevier, vol. 121(11), pages 1154-1160.

    More about this item

    Keywords

    uncertainty; equity; cost-effectiveness; public health;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pra:mprapa:29772. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Joachim Winter (email available below). General contact details of provider: https://edirc.repec.org/data/vfmunde.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.