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NICE's use of cost effectiveness as an exemplar of a deliberative process

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  • Culyer, Anthony J.

Abstract

This paper seeks to test 12 conjectures about the predicted use of deliberative processes by applying them to the technology assessment procedures used by the National Institute for Health and Clinical Excellence (NICE) in England and Wales. A deliberative process is one that elicits and combines evidence of different kinds and from different sources in order to develop guidance in the present case, guidance for a health care system. A deliberative process entails the integration of three kinds of evidence: scientific context-free evidence about the general clinical potential of a technology, scientific context-sensitive evidence about particular evidence in realistic scenarios, and colloquial evidence to fit context-free scientific evidence into a context and to supply the best evidence short of scientific evidence to fill in any relevant gaps. It is shown that NICE s appraisals procedures and, in particular, its approach to cost effectiveness, entail both the weighing of each of these types of evidence and can be seen as rational responses to the 12 conjectures.

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Bibliographic Info

Article provided by Cambridge University Press in its journal Health Economics, Policy and Law.

Volume (Year): 1 (2006)
Issue (Month): 03 (July)
Pages: 299-318

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Handle: RePEc:cup:hecopl:v:1:y:2006:i:03:p:299-318_00

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Cited by:
  1. Milewa, Timothy, 2008. "Representation and legitimacy in health policy formulation at a national level: Perspectives from a study of health technology eligibility procedures in the United Kingdom," Health Policy, Elsevier, vol. 85(3), pages 356-362, March.
  2. Helen Dakin & Nancy Devlin & Yan Feng & Nigel Rice & Phill O’Neill & David Parkin, 2013. "The influence of cost-effectiveness and other factors on NICE decisions," Working Papers 093cherp, Centre for Health Economics, University of York.

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