OBJECTIVES: Underlying all NICE decisions is one fundamental social value judgement; to demonstrate this NICE introduced severity modifiers. Following the NICE methods review, NICE recommends using direct EQ-5D-3L to inform quality of life (QoL) by age and sex (Hernandez et al., 2022), as opposed to previous methods by Ara and Brazier (2011). Changes to general population QoL highlights the importance for pharmaceutical companies to understand how NICE values the lives of males and females when assessing technologies and how it impacts the products willingness to pay (WTP) threshold.

METHODS: Quality-adjusted life expectancy (QALE) is the basis for calculating quality-adjusted life years (QALY) shortfall. Estimating QALE requires four items: 1. Mean age and sex; 2. National life tables; 3. Quality of life by age and sex; 4. Discount rate. Implementing the latest NICE guidance, MAP Patient Access (MAP) has updated their baseline healthy population model using Hernandez EQ-5D-3L scores as its reference case for general population QoL. Disease-specific inputs were used from TA276; the discounted comparator arm QALYs (8.49) and age at diagnosis (21 years) were constant.

RESULTS: Different scenarios were explored by varying the proportion of males to females at baseline. Results were compared to NICE’s previous modelling methodologies using Ara and Brazier (2011). Absolute proportional QALY shortfall (AS) was higher when there was a larger proportion of males at baseline. However, when using Ara and Brazier (2011) as the reference case, AS was higher for females.

CONCLUSIONS: When adopting recent NICE methods guidance, results suggest NICE values males lives more than females’ where they have previously valued females lives over males’. Although there is an inconsistency with how NICE value the lives of males and females, a medium severity was calculated for all scenarios, suggesting that the differences will not drastically impact the WTPs thresholds in technology appraisals.