Utilisation of Societal Costs in the NICE HST Approvals Compared to European Agencies

OBJECTIVES: Society can, especially when faced with paediatric, chronic, or serious illnesses, invoke serious indirect economic burdens through factors such as changes to working patterns and loss of schooling in both patients and carers. This work seeks to assay how often theses factors are considered in the HTA process.

METHODS: All drugs assessed through the Highly Specialised Technology (HST) pathway by the National Institute for Care Excellence (NICE) were reviewed to search for relevant information pertaining to reduction of societal costs due to introduction of the new drug and the societal benefits evident as a result. Any relevant drugs were then queried against 3 other European HTA agencies (Scottish Medicines Consortium in Scotland, Haute Autorité de Santé in France, and the Gemeinsamer Bundesausschuss in Germany) to compare for mentions of societal costs.

RESULTS:

Of the 19 NICE HST appraisals, 3 (15.8%) contained mention of societal costs. Of these, all cited increased contribution to society via continuation of school or employment, along with decreased costs associated with travel and housing for specialist treatment, and all were approved. The same 3 drugs were all approved in France, and 2/3 in Germany, though only 1 of the appraisals in France mentioned societal costs, with no mentions in Germany. In Scotland, 1/3 appraisals were submitted. Here, wider societal care perspectives, such as caregiver QALYs and social care costs, were considered as part of the ultra-orphan initial assessment.

CONCLUSIONS:

New drugs can influence societal benefits along with clinical and economic benefits. When included in HTA submissions, committees seem receptive to their arguments. More companies across Europe could consider the addition of information pertaining to societal costs, as this could enhance likelihood of positive recommendation outcomes.