Development of an NCPE-Adjusted Base Case: Assessment and Adjustment of Applicant Base Cases From the Perspective of a Health Technology Assessment Body

OBJECTIVES: To review the National Centre for Pharmacoeconomics (NCPE) adjustments to the Applicants’ base case within health technology assessment (HTA) submissions. The assessment aims to examine the number of changes made, the nature of these changes, the impact of changes made and the most common categories of change across all submissions examined.

METHODS: HTA assessments completed between April 2022 and February 2024 were reviewed. Data relating to the Applicant and NCPE-adjusted base cases were extracted. An Excel-based data extraction sheet was developed and refined. A combination of qualitative and quantitative methods were employed to analyze the data extracted and compiled. Quantitative analysis involved examining the percentage change in cost-effectiveness results associated with each change in the NCPE-adjusted base case and the impact of individual changes on the results. Qualitative analysis involved grouping changes made by the NCPE Review Group into categories reflecting similar changes and subsequently examining each category in more detail to identify and present key learnings for future HTA submissions.

RESULTS: Of the 49 submissions reviewed, 36 submissions involved the development of an NCPE-adjusted base case. The number of changes required to develop the NCPE-adjusted base case ranged from 1 to 8 changes. In almost all submissions, the NCPE-adjusted base case resulted in an increased incremental cost-effectiveness ratio (ICER). The most common categories identified for NCPE-adjusted changes were treatment effects, costs, and health-related quality of life changes.

CONCLUSIONS: The number of adjustments required to develop the NCPE-adjusted base case varies across submissions. Further investigation into the relationship between the number of changes made and the time required to review each submission was prompted. This research will provide useful direction and recommendations to Applicants intending to submit HTA submissions to the NCPE in the future.