Format

Send to

Choose Destination
See comment in PubMed Commons below
Health Econ Policy Law. 2014 Apr;9(2):119-41. doi: 10.1017/S1744133113000030. Epub 2013 May 21.

Decision making by NICE: examining the influences of evidence, process and context.

Author information

1
1 Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
2
2Professor of Social Policy, Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
3
3Principal Research Fellow, Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.

Erratum in

  • Health Econ Policy Law. 2014 Oct;9(4):435. Fernandez, Jose-Luis [corrected to Fernández, José-Luis].

Abstract

The National Institute for Health and Clinical Excellence (NICE) provides guidance to the National Health Service (NHS) in England and Wales on funding and use of new technologies. This study examined the impact of evidence, process and context factors on NICE decisions in 2004-2009. A data set of NICE decisions pertaining to pharmaceutical technologies was created, including 32 variables extracted from published information. A three-category outcome variable was used, defined as the decision to 'recommend', 'restrict' or 'not recommend' a technology. With multinomial logistic regression, the relative contribution of explanatory variables on NICE decisions was assessed. A total of 65 technology appraisals (118 technologies) were analysed. Of the technologies, 27% were recommended, 58% were restricted and 14% were not recommended by NICE for NHS funding. The multinomial model showed significant associations (p ⩽ 0.10) between NICE outcome and four variables: (i) demonstration of statistical superiority of the primary endpoint in clinical trials by the appraised technology; (ii) the incremental cost-effectiveness ratio (ICER); (iii) the number of pharmaceuticals appraised within the same appraisal; and (iv) the appraisal year. Results confirm the value of a comprehensive and multivariate approach to understanding NICE decision making. New factors affecting NICE decision making were identified, including the effect of clinical superiority, and the effect of process and socio-economic factors.

PMID:
23688554
DOI:
10.1017/S1744133113000030
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Cambridge University Press
    Loading ...
    Support Center