Estimating ‘Costs’ for Cost-Effectiveness Analysis
- 151 Downloads
Since 1999, the National Institute for Health and Clinical Excellence (NICE) Technology Appraisal Programme has been charged with producing guidance for the NHS in England and Wales on the appropriate use of new and existing healthcare programmes. Guidance is based on an assessment of a number of factors, including cost effectiveness. The identification, measurement and valuation of costs are important components of any cost-effectiveness analysis. However, working through these steps raises a number of important methodological questions. For example, how should ‘future’ resource use be estimated, and is there a need to consider all ‘future’ costs? Given that NICE produces national guidance, should national unit cost data be used to value resources or should local variations in negotiated prices be taken into account? This paper was initially prepared as a briefing paper as part of the process of updating NICE’s 2004 Guide to the Methods of Technology Appraisal for a workshop on ‘costs’. It outlines the issues that were raised in the original briefing paper and the subsequent questions that were discussed at the workshop.
KeywordsEconomic Evaluation Future Cost Briefing Paper Relevant Cost Estimate Unit Cost
This paper was initially prepared as a briefing paper for NICE as part of the process of updating the Institute’s 2004 Guide to the Methods of Technology Appraisal. The work was funded by NICE through its Decision Support Unit, which is based at the universities of Sheffield, Leicester, York, Leeds and at the London School of Hygiene and Tropical Medicine.
The author has no conflicts of interest that are directly relevant to the content of this article.
- 1.National Institute for Health and Clinical Excellence. Guide to the technology appraisals process. London: NICE, 2004 [online]. Available from URL: http://www.nice.org.uk/niceMedia/pdf/TAP_Methods.pdf [Accessed 2007 Jun 4]Google Scholar
- 4.Morris SN, Devlin N, Parkin D. Economic analysis in health care. Chichester: John Wiley and Sons, Ltd, 2007Google Scholar
- 5.Drummond MF, Sculpher MJ, Torrance GW, et al. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press, 2005Google Scholar
- 6.Claxton K, Sculpher M, Culyer AJ. Mark versus Luke? Appropriate methods for the evaluation of public health interventions [research paper]. York: University of York, Centre for Health Economics, 2007 Nov [online]. Available from URL: http://www.york.ac.uk/inst/che/pdf/rp31.pdf [Accessed 2008 Jul 11]Google Scholar
- 9.Gold MR, Siegel JE, Russell LB, et al. Cost-effectiveness analysis in health and medicine. New York: Oxford University Press, 1996Google Scholar
- 13.National Collaborating Centre for Cancer. Prostate cancer: diagnosis and treatment [online]. Available from URL: http://www.nice.org.uk/nicemedia/pdf/CG58FullGuideline.pdf [Accessed 2008 May 1]Google Scholar
- 17.Drummond M, McGuire A. Economic evaluation in health care: merging theory with practice. New York: Oxford University Press, 2001Google Scholar
- 21.UK Department of Health. NHS reference costs 2006–07. London: DH, 2008 Feb [online]. Available from URL: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_082571 [Accessed 2008 Mar 1]Google Scholar
- 22.Buxton MJ, Acheson R, Caine R, et al. Costs and benefits of the heart transplant programmes at Harefield and Papworth Hospitals [research report no.2]. London: Department of Health and Social Security, 1985Google Scholar