Ni3 Nice's Cost-Effectiveness Threshold Revisited: New Evidence on the Influence of Cost-Effectiveness and Other Factors on Nice Decisions

Devlin, Nancy; Dakin, Helen; Rice, Nigel; Parkin, David; O’Neill, Peter

doi:10.1016/s1098-3015(11)71876-9

Cited by 5 publications

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“…[33] Certainly, many submissions did not require the development or discussion of sophisticated economic analyses. There may be legitimate systematic factors (both evidentiary and nonevidentiary) to underpin these results.…”

Section: Discussionmentioning

confidence: 99%

Common Drug Review Recommendations

Rocchi¹,

Miller²,

Hopkins

et al. 2012

PharmacoEconomics

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This analysis documented an evidence-driven process that simultaneously weighted multiple factors. Clinical uncertainty and price considerations, but not economic results, had a strong impact on the recommendations. Insufficiency of clinical evidence may have resulted from the gap in evidence available at the time of product launch and the absence of demonstrated benefits to support innovative drugs.

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Section: Discussionmentioning

confidence: 99%

Common Drug Review Recommendations

Rocchi¹,

Miller²,

Hopkins

et al. 2012

PharmacoEconomics

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“…Instead, the drugs' estimated costeffectiveness was in the range of £38,000-£39,000 per quality-adjusted life-year. 18,19 The institute provisionally rejected six cancer drugs in 2008 on the ground of poor cost-effectiveness. Initially, differing interpretations of National Health Service rules resulted in denial of free care to some who purchased these nonrecommended drugs privately.…”

Section: An International Reviewmentioning

confidence: 99%

Therapies For Advanced CancersPose A Special Challenge For Health Technology Assessment Organizations In Many Countries

Neumann

Bliss²,

Chambers³

2012

Health Affairs

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“…In Canada, cost-effectiveness did not influence the recommendation once clinical factors had been taken into account; rather, price remained as one of four statistically significant predictors of a recommendation. 15 In the United Kingdom, Devlin et al 16 found that cost-effectiveness explained 85% of NICE decisions. INESSS recommendations have not been studied in previously published research.…”

Section: Discussionmentioning

confidence: 99%

Oncology drug health technology assessment recommendations: Canadian versus UK experiences

Chabot¹,

Rocchi²

2014

CEOR

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BackgroundCanada has two health technology assessment (HTA) agencies responsible for oncology drug funding recommendations: the Institut National d’Excellence en Santé et Services Sociaux (INESSS) for the province of Québec and the pan-Canadian Oncology Drug Review for the rest of Canada. The objective of the research was to review and compare the recommendations of these two agencies alongside an international comparator – the National Institute for Health and Care Excellence (NICE) in the United Kingdom – with respect to their recommendations records and the influence of clinical and cost-effectiveness evidence on the recommendations.MethodsRecommendations were identified from the three agencies from January 1, 2002 to June 1, 2013. Recommendations were limited to five cancer sites (lung, breast, colon, kidney, blood) and to metastatic/advanced settings. Descriptive analyses examined the frequency of positive recommendations and factors related to a positive recommendation. For each recommendation, only publicly available information posted on the agency website was used to abstract data.ResultsThere was a wide variation in the rate of positive recommendations, ranging from 48% for NICE to 95% for Canada’s national process (among the 74% of its recommendations that were publicly posted). Interagency agreement was low, with full agreement for only six of the 14 drugs commonly reviewed by all three agencies. Evidence of a survival gain was not necessary for a positive recommendation; progression-free survival was acceptable. Different approaches were taken when addressing unacceptable cost-effectiveness. NICE was most likely to yield a negative recommendation on these grounds, whereas Canada’s national process was most likely to yield a positive recommendation with a required pricing arrangement.ConclusionIn this analysis, the primary reason for the observed divergence between agency recommendations appeared to be the availability of mechanisms in each jurisdiction to address cost-effectiveness subsequent to the HTA assessment process. Furthermore, caution is needed when interpreting cross-agency comparisons between HTA agencies, as recommendations may not correspond directly to subsequent funding decisions and actual patient access. This may be a concern, given the high international profile of assessments conducted by the reviewed HTA agencies.

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Ni3 Nice's Cost-Effectiveness Threshold Revisited: New Evidence on the Influence of Cost-Effectiveness and Other Factors on Nice Decisions

Cited by 5 publications

References 0 publications

Common Drug Review Recommendations

Common Drug Review Recommendations

Therapies For Advanced CancersPose A Special Challenge For Health Technology Assessment Organizations In Many Countries

Oncology drug health technology assessment recommendations: Canadian versus UK experiences

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