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Key
Features: |
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| Title and year of the Document | Guide to the Methods of Technology Appraisals, June 2008 |
| Affiliation of authors | National Insititue for Health and Clinical Excellence (NICE) |
| Main policy objective | To provide an overview of the principles and methods of health technology assessment and appraisal within the context of the NICE appraisal process. It describes key principles of appraisal methodology and is a guide for all organisations considering submitting evidence to the technology appraisal programme of the Institute. |
| Standard reporting format included | No, however developed a reference case for cost-effectiveness analysis. |
| Disclosure | No |
| Target audience of funding/ author’s interests | All organizations considering submitting evidence to the Technology Appraisal Program of the Institute. |
| Perspective | For the reference case, the perspective on outcomes should be all direct health effects, whether for patients or, when relevant, other people (principally carers). |
| Indication | Clearly define the spectrum of diseases |
| Target population | Yes, includes age and sex distribution and co-morbidities |
| Subgroup analysis | Yes |
| Choice of comparator | Relevant comparators for the technology being appraised are those routinely used in the NHS, and therapies regarded as best practice when this differs from routine practice. |
| Time horizon | The time horizon for estimating clinical and cost effectiveness should be sufficiently long to reflect all important differences in costs or outcomes between the technologies being compared. |
| Assumptions required | Yes |
| Preferred analytical technique | For the reference case, cost-effectiveness (specifically cost–utility) analysis is the preferred form of economic evaluation. |
| Costs to be included | Potential direct and indirect resource costs for the NHS and PSS that would be expected. |
| Source of costs | Current official listing published by the Department of Health and/or the Welsh Assembly Government |
| Modeling | Yes |
| Systematic review of evidences | Yes |
| Preference for effectiveness over efficacy | Yes |
| Preferred outcome measure | Given its widespread use, the QALY is considered to be the most appropriate generic measure of health benefit that reflects both mortality and HRQL effects. |
| Preferred method to derive utility | Patient derived EQ-5D values with UK societal tarrifs applied; alternatively TTO valuation using a representative sample of the public |
| Equity issues stated | Yes, an additional QALY has the same weight regardless of the other characteristics of the individual receiving the health benefit |
| Discounting costs | Base: 3.5%; SA: 0~6% |
| Discounting outcomes | Base: 3.5%; SA: 0~6% |
| Sensitivity analysis-parameters and range | All inputs used in the analysis will be estimated with a degree of imprecision. Appropriate ways of presenting uncertainty in cost-effectiveness data parameter uncertainty include confidence ellipses and scatter-plots on the cost-effectiveness plane (when the comparison is restricted to two alternatives) and cost-effectiveness acceptability curves. The presentation of cost-effectiveness acceptability curves should include a representation and explanation of the cost-effectiveness acceptability frontier. |
| Sensitivity analysis-methods | Probabilistic SA. |
| Presenting results | All data used to estimate clinical and cost effectiveness should be presented clearly in tabular form and include details of data sources. |
| Incremental analysis | Yes |
| Total C/E | Yes |
| Portability of results (Generalizability) | In NHS context |
| Financial impact analysis | Yes, the cost should be disaggregated by appropriate generic organization (NHS, PSS, hospital, primary care) and budgetary categories (drugs, staffing, consumables, capital). |
| Mandatory or recommended or voluntary | Recommended |
