HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Monday, 4 February 2013

The real NICE threshold

A study by health economists at the University of York has, for the first time, produced an empirical estimate of the impact on other NHS patients of new and more costly drugs and other treatments.

NICE assesses the health benefits of new drugs and other treatments. It also assesses whether these benefits are greater than the health likely to be lost for other NHS patients as other treatments are displaced to accommodate the additional NHS costs. To make this assessment NICE uses a ‘threshold’,which represents how much additional NHS cost would displace an amount of health; measured by quality-adjusted life years (QALY).

Since 2004 NICE has used a threshold range of £20,000 to £30,000 per QALY. It has been widely recognised for many years that this range is not based on evidence. The researchers at York have estimated a more accurate threshold to be £18,317 per QALY (based on 2008 expenditure), which they consider, for various reasons to be an upper estimate.

The paper is available at http://www.york.ac.uk/che/publications/in-house/

If you don’t want to read all 412 pages, there are summaries and other media formats available.