Thursday 12 May 2011, 1.30PM
Speaker(s): Eldon Spackman and Sebastian Hinde, CHE
Abstract: The cost-effectiveness threshold is an estimate of the health forgone as other NHS activities are displaced to accommodate the additional costs of new technologies recommended in NICE guidance. To set this threshold NICE needs an estimate of what is likely to be forgone on average across the NHS as we currently find it. This means the threshold may change as circumstances and the NHS changes; tending to rise with increases in budget and health care costs but tending to fall with increases in the efficiency of the NHS. Currently NICE uses a threshold range of £20,000 to £30,000 per quality adjusted life year gained, where additional considerations are required towards the upper bound. The empirical basis of this range of values is very limited. At best it represents an informal assessment of the health gained by some of the least productive of the activities currently undertaken by the NHS. It is widely recognised, by NICE and the House of Commons Health Committee among many others, that the current range ought to be more firmly based on empirical analysis. Explicit scientific methods for estimation are required which will provide accountability so that estimates can be scrutinised by a range of stakeholders. Since estimates of the threshold will need to be periodically revised, methods which make best use of routinely available NHS data are needed. We use programme budgeting data to examine the relationship between local spending and associated disease-specific outcomes across all 23 programmes of care. Previous work has demonstrated the link between expenditure and disease specific mortality and has been used to calculate estimates of the marginal cost per life-year gained. We have extended these methods in a number of important respects including expressing outcomes in terms of quality as well as length of life.
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Location: Alcuin A Block A019/A020
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Economic evaluation seminar dates
- 24 November 2011
Paul Revill, University of York
- 7 December 2011
Marie-Jeanne Aarts, Maastricht University, The Netherlands
- 23 February 2012
Patrícia Coelho de Soárez, MPH, PhD from the University of São Paulo, Brazil.