NICECitizensCouncil07Presentation(kc).pptVIP

Making Decisions in Health Care: Cost-effectiveness and the Value of Evidence Karl Claxton Centre for Health Economics, Department of Economics and Related Studies, University of York, NICE Appraisals Committee Overview What decisions need to be made? Should a technology be adopted? How uncertain is this decision? Is more evidence needed? What can and should NICE do? What are the decisions? Should a technology be adopted given existing information? Which clinical strategies are worthwhile? For which patient groups? Is current evidence sufficient to support use in NHS? Do we need more evidence? What type of evidence is required? What additional research should be conducted to provide this evidence? What are the decisions? Should a technology be adopted given existing information? Which clinical strategies are worthwhile? For which patient groups? Is current evidence sufficient to support use in NHS? Do we need more evidence? What type of evidence is required? What additional research should be conducted to provide this evidence? Is it worthwhile? What is an improvement in health? Gain in life expectancy Improvement in quality of life But what about costs? Is it cost-effective? What do we need? Estimate QALYs gained and costs Over time (often patient’s life time) For each alternative For each patient group Need to Combine evidence Should a technology be adopted? What are the decisions? Should a technology be adopted given existing information? Which clinical strategies are cost-effective? For which patient groups? Is current evidence sufficient to support use in NHS? Do we need more evidence? What type of evidence is required? What additional research should be conducted to provide this evidence? How uncertain is a decision? How uncertain is the decision? Why does uncertainty matter? Do we need more evidence? Is current evidence sufficient? Summary Uncertainty matters because we might need more evidence Value of evidence (information) How uncertain is