Confronting NICE decision rules with NICE guidelines for technology assessment: the case of unrelated medical care

Abstract: Life-saving medical technologies result in additional demand for health care due to increased life expectancy. However, most economic evaluations do not include all medical costs caused by increased life expectancy. In spite of strong arguments against this practice, it is still supported by many guidelines for economic evaluations. NICE guidelines for technology appraisal are no exception and dictate that only medical costs in life years gained related to the intervention should be taken into account.

In this presentation I will confront NICE decision rules with the current practice of excluding costs of unrelated medical care. I will argue that a) given the decision rules of NICE costs of unrelated medical care should be routinely included b) including future unrelated medical costs can have a major impact on the ICER c) consistent exclusion of these costs is not an option.