Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-27T20:07:10.796Z Has data issue: false hasContentIssue false
  • English
  • Français

Exploration of the difference in results of economic submissions to the National Institute of Clinical Excellence by manufacturers and assessment groups

Published online by Cambridge University Press:  18 January 2007

Deven Chauhan ,
Alec H. Miners  and
Alastair J. Fischer
Deven Chauhan
Affiliation:
Office of Health Economics
Alec H. Miners
Affiliation:
London School of Hygiene and Tropical Medicine
Alastair J. Fischer
Affiliation:
St. George's, University of LondonandNational Institute for Health and Clinical Excellence
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: A recent study showed that estimates of cost-effectiveness submitted to National Institute for Health and Clinical Excellence (NICE) by manufacturers had significantly lower incremental cost-effectiveness ratios (ICERs) than those submitted by university-based Assessment Groups. This study extends that analysis.

Methods: Data were abstracted from relevant NICE documentation for thirty-two of eighty-two possible appraisals.

Results: The results from the analysis showed that sources of the difference in ICERs appear to be the effectiveness estimates relating to the comparator technology and the cost estimates relating to the technology under evaluation. That is, manufacturers estimated lower average benefits for the comparator technology and lower costs relating to the technology under evaluation compared with estimates submitted by the Assessment Groups.

Conclusions: These findings may be particularly important, given the introduction of the “Single Technology Appraisal.” Considerable difficulties were encountered when undertaking this study, highlighting, above all else, the complexity of explaining why results from economic evaluations purporting to answer the same question diverge.

Keywords

Cost-effectiveness analysisBias (epidemiology)Drug industryTechnology assessmentbiomedical
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 23 , Issue 1 , January 2007 , pp. 96 - 100
Copyright
© 2007 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bell CM, Urbach DR, Ray JG, et al. 2006 Bias in published cost effectiveness studies: Systematic review. BMJ. 332: 699– 703.Google Scholar
Buxton MJ, Akehurst R. 2006 How NICE is the UK's fast-track system? Scrip Magazine. 152: 24– 25.Google Scholar
Ferner RE, McDowell SE. 2006 How NICE may be outflanked. BMJ. 332: 1268– 1271.Google Scholar
Freemantle N, Mason J. 1997 Publication bias in clinical trials and economic analyses. Pharmacoeconomics 12: 10– 16.Google Scholar
Friedberg M, Saffran B, Stinson TJ, et al. 1999 Evaluation of conflict of interest in economic analyses of new drugs used in oncology. JAMA. 282: 1453– 1457.Google Scholar
Hill S, Garattini S, van Loenhout J, O'Brien BJ, de Joncheere K. 2003. Technology appraisal programme of the national institute for clinical excellence. Geneva: WHO;
Lexchin J, Bero LA, DJulbegovic B, Clark O. 2003 Pharmaceutical industry sponsorship and research outcome and quality: Systematic review. BMJ. 326: 1167– 1170.Google Scholar
Miners AH, Garau M, Fidan D, Fischer AJ. 2005 Comparing estimates of cost-effectiveness to the National Institute for Clinical Excellence (NICE) by different organisation: Retrospective study. BMJ. 330: 65– 68.Google Scholar
National Institute for Health and Clinical Excellence. 2006. Press release: NICE to issue faster drugs guidance for the NHS. National Institute for Clinical Excellence, London, 2005. Available at: http://www.nice.org.uk/download.aspx?o=277752. Accessed March