A Review of NICE Methods Across Health Technology Assessment Programmes: Differences, Justifications and Implications. Brockis, E., Marsden, G., Cole, A., & Devlin, N. abstract bibtex Background: All NICE decisions exert an influence on the allocation of fixed NHS budgets, but decisions for different types of health interventions (for example drugs and devices) are handled via different ‘programmes’ within NICE. These different programmes use different methods and decision processes. To date there has been no systematic comparison of methods across these programmes. Objectives: To carry out a systematic comparison of five of NICE’s health technology assessment programmes (Technology Appraisal Programme, Medical Technologies Guidance, Diagnostic Assessment Programme, Highly Specialised Technologies Programme, and Clinical Guidelines) with the aim of establishing how differences in methods and processes between the programmes may impact on allocative efficiency within the NHS. Such a comparison has not been undertaken previously. Methods: Data were extracted from the NICE programme manuals to allow for a systematic comparison between the programmes. Eight qualitative interviews were carried out with NICE members of staff and committee members to explore the reasons for the differences found. Results: The processes overall were broadly similar. However, there were differences in the required review period (the amount of time after which the evidence must be reviewed to see if the guidance needs updating), and methods of evaluation, specifically the provision of a reference case, the requirement for and type of economic analysis, and the decision making criteria used for appraisal. Conclusion: All NICE programmes affect the allocation of resources from the same fixed NHS budget. Differences in approaches between the programmes could therefore lead to the misallocation of resources. Many of the differences found can be justified on grounds of practicality and relevance to the health technologies under assessment. However, from a strict utilitarian view there are several potential areas of inefficiency, although many of these are eliminated or reduced if an egalitarian view is taken. The challenge is finding the optimal balance within the equity-efficiency trade-off, and determining where society is willing trade health gains between different people.
@article{brockis_review_nodate-1,
title = {A {Review} of {NICE} {Methods} {Across} {Health} {Technology} {Assessment} {Programmes}: {Differences}, {Justifications} and {Implications}},
abstract = {Background: All NICE decisions exert an influence on the allocation of fixed NHS budgets, but decisions for different types of health interventions (for example drugs and devices) are handled via different ‘programmes’ within NICE. These different programmes use different methods and decision processes. To date there has been no systematic comparison of methods across these programmes. Objectives: To carry out a systematic comparison of five of NICE’s health technology assessment programmes (Technology Appraisal Programme, Medical Technologies Guidance, Diagnostic Assessment Programme, Highly Specialised Technologies Programme, and Clinical Guidelines) with the aim of establishing how differences in methods and processes between the programmes may impact on allocative efficiency within the NHS. Such a comparison has not been undertaken previously. Methods: Data were extracted from the NICE programme manuals to allow for a systematic comparison between the programmes. Eight qualitative interviews were carried out with NICE members of staff and committee members to explore the reasons for the differences found. Results: The processes overall were broadly similar. However, there were differences in the required review period (the amount of time after which the evidence must be reviewed to see if the guidance needs updating), and methods of evaluation, specifically the provision of a reference case, the requirement for and type of economic analysis, and the decision making criteria used for appraisal. Conclusion: All NICE programmes affect the allocation of resources from the same fixed NHS budget. Differences in approaches between the programmes could therefore lead to the misallocation of resources. Many of the differences found can be justified on grounds of practicality and relevance to the health technologies under assessment. However, from a strict utilitarian view there are several potential areas of inefficiency, although many of these are eliminated or reduced if an egalitarian view is taken. The challenge is finding the optimal balance within the equity-efficiency trade-off, and determining where society is willing trade health gains between different people.},
language = {en},
author = {Brockis, Emma and Marsden, Grace and Cole, Amanda and Devlin, Nancy},
pages = {37},
file = {Brockis et al. - A Review of NICE Methods Across Health Technology .pdf:/Users/neil.hawkins/Zotero/storage/IK9F2Z3N/Brockis et al. - A Review of NICE Methods Across Health Technology .pdf:application/pdf},
}
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Objectives: To carry out a systematic comparison of five of NICE’s health technology assessment programmes (Technology Appraisal Programme, Medical Technologies Guidance, Diagnostic Assessment Programme, Highly Specialised Technologies Programme, and Clinical Guidelines) with the aim of establishing how differences in methods and processes between the programmes may impact on allocative efficiency within the NHS. Such a comparison has not been undertaken previously. Methods: Data were extracted from the NICE programme manuals to allow for a systematic comparison between the programmes. Eight qualitative interviews were carried out with NICE members of staff and committee members to explore the reasons for the differences found. Results: The processes overall were broadly similar. However, there were differences in the required review period (the amount of time after which the evidence must be reviewed to see if the guidance needs updating), and methods of evaluation, specifically the provision of a reference case, the requirement for and type of economic analysis, and the decision making criteria used for appraisal. Conclusion: All NICE programmes affect the allocation of resources from the same fixed NHS budget. Differences in approaches between the programmes could therefore lead to the misallocation of resources. Many of the differences found can be justified on grounds of practicality and relevance to the health technologies under assessment. However, from a strict utilitarian view there are several potential areas of inefficiency, although many of these are eliminated or reduced if an egalitarian view is taken. 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However, there were differences in the required review period (the amount of time after which the evidence must be reviewed to see if the guidance needs updating), and methods of evaluation, specifically the provision of a reference case, the requirement for and type of economic analysis, and the decision making criteria used for appraisal. Conclusion: All NICE programmes affect the allocation of resources from the same fixed NHS budget. Differences in approaches between the programmes could therefore lead to the misallocation of resources. Many of the differences found can be justified on grounds of practicality and relevance to the health technologies under assessment. However, from a strict utilitarian view there are several potential areas of inefficiency, although many of these are eliminated or reduced if an egalitarian view is taken. 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