Table 1. Factors justifying recommendation of a technology above £20,000/QALY.
| 2004 Methods guide (3rd edition) [36] | 2008 Methods guide (4th edition) [41] | 2013 Methods guide (5th edition) [46] | 2008 SVJ (2nd edition) [40] |
|---|---|---|---|
| The degree of uncertainty surrounding the calculation of ICERs | The degree of certainty around the ICER. In particular, the Committee will be more cautious about recommending a technology when they are less certain about the ICERs presented | As per 2008 Methods guide | NICE should not recommend an intervention (that is, a treatment, procedure, action or programme) if there is no evidence, or not enough evidence, on which to make a clear decision |
| The innovative nature of the technology | The innovative nature of the technology, specifically if the innovation adds demonstrable and distinctive benefits of a substantial nature which may not have been adequately captured in the QALY measure | As per 2008 Methods guide | Decisions about whether to
recommend interventions should not be based on evidence of their
relative costs and benefits alone. NICE must consider other factors when
developing its guidance, including the need to distribute health
resources in the fairest way within society as a whole NICE can recommend that use of an intervention is restricted to a particular group of people within the population (for example, people under or over a certain age, or women only), but only in certain circumstances When choosing guidance topics, developing guidance and supporting those who put its guidance into practice, the Institute should actively consider reducing health inequalities including those associated with sex, age, race, disability and socioeconomic status |
| The particular features of the condition and population receiving the technology | Not included | The technology meets the criteria for special consideration as a ‘life-extending treatment at the end of life’ | |
| Where appropriate, wider societal costs and benefits | Not included | Aspects that relate to non-health objectives of the NHS | |
| Not included | Whether there are strong reasons to indicate that the assessment of the change in health-related quality-of-life has been inadequately captured, and may therefore misrepresent the health utility gained | As per 2008 Methods guide | No close equivalent |