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After 20 Years of Using Economic Evaluation, Should NICE be Considered a Methods Innovator?

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  • Mark Sculpher

    (University of York)

  • Stephen Palmer

    (University of York)

Abstract

The National Institute for Health and Care Excellence (NICE) is only one of several organisations internationally that uses economic evaluation as part of decision making regarding funding and pricing of new medical technologies. However, it can be argued that NICE has developed a more prominent international profile than most in their use of economics. After 20 years of operation, it is timely to assess the extent of NICE’s achievements, including the economic evaluation methods it has used and its willingness to adapt these as new evaluative approaches emerge and when NICE faces particular policy challenges. This paper considers some of the important policy and contextual developments in the UK over the last 20 years and how these may have shaped NICE’s approach to economic evaluation. It then assesses key areas of NICE methods, including perspective, defining benefits, modelling and uncertainty. The paper concludes that NICE has provided important support for the development of new methods, in particular through its role in identifying priorities for methods research funding and its sponsorship of the NICE Decision Support Unit. However, potentially important developments in methods in a number of important areas have yet to be formally included in NICE’s methods guidance and this should be addressed in the Institute’s 2019/2020 methods review.

Suggested Citation

  • Mark Sculpher & Stephen Palmer, 2020. "After 20 Years of Using Economic Evaluation, Should NICE be Considered a Methods Innovator?," PharmacoEconomics, Springer, vol. 38(3), pages 247-257, March.
  • Handle: RePEc:spr:pharme:v:38:y:2020:i:3:d:10.1007_s40273-019-00882-6
    DOI: 10.1007/s40273-019-00882-6
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    References listed on IDEAS

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    1. Ash Bullement & Matthew Taylor & Sam Thomas McMordie & Errol Waters & Anthony James Hatswell, 2019. "NICE, in Confidence: An Assessment of Redaction to Obscure Confidential Information in Single Technology Appraisals by the National Institute for Health and Care Excellence," PharmacoEconomics, Springer, vol. 37(11), pages 1383-1390, November.
    2. Miqdad Asaria & Susan Griffin & Richard Cookson & Sophie Whyte & Paul Tappenden, 2013. "Distributional Cost-Effectiveness Analysis of Health Care Programmes," Working Papers 091cherp, Centre for Health Economics, University of York.
    3. Simon Walker & Susan Griffin & Miqdad Asaria & Aki Tsuchiya & Mark Sculpher, 2019. "Striving for a Societal Perspective: A Framework for Economic Evaluations When Costs and Effects Fall on Multiple Sectors and Decision Makers," Applied Health Economics and Health Policy, Springer, vol. 17(5), pages 577-590, October.
    4. Andrew H. Briggs & David E. Wonderling & Christopher Z. Mooney, 1997. "Pulling cost‐effectiveness analysis up by its bootstraps: A non‐parametric approach to confidence interval estimation," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 327-340, July.
    5. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    6. Culyer, Anthony J., 2006. "NICE's use of cost effectiveness as an exemplar of a deliberative process," Health Economics, Policy and Law, Cambridge University Press, vol. 1(3), pages 299-318, July.
    7. Xudong Du & Mier Li & Ping Zhu & Ju Wang & Lisha Hou & Jijie Li & Hongdao Meng & Muke Zhou & Cairong Zhu, 2018. "Comparison of the flexible parametric survival model and Cox model in estimating Markov transition probabilities using real-world data," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-13, August.
    8. Karl Claxton & Steve Martin & Marta Soares & Nigel Rice & Eldon Spackman & Sebastian Hinde & Nancy Devlin & Peter C Smith & Mark Sculpher, 2013. "Methods for the estimation of the NICE cost effectiveness threshold," Working Papers 081cherp, Centre for Health Economics, University of York.
    9. Karl Claxton & Mark Sculpher & Chris McCabe & Andrew Briggs & Ron Akehurst & Martin Buxton & John Brazier & Tony O'Hagan, 2005. "Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 339-347, April.
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    Cited by:

    1. Meindert Boysen & Ian Watson, 2020. "Reflections on NICE’s Uptake of New Methods: Past, Present, and the 2020 Review," PharmacoEconomics, Springer, vol. 38(3), pages 243-245, March.

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