Details of HTA project in progress
Last updated: 15 July 2008 - Next update due: 22 July 2008
Research type: |
HTA Technology Assessment Report |
Project title: |
Probabilistic sensitivity analysis: an audit of current practice and a review of its use and value in decision making |
Project ref: |
07/56/01 |
Cost: |
This project has been commissioned by the HTA programme on a call-off contract basis. |
Chief Investigator : |
West Midlands Health Technology Assessment Collaboration (WMHTAC), University of Birmingham |
Start Date: |
May 2007. |
Publication date: |
Early 2009. This date takes account of time for report preparation and printing based on current average times for these activities. |
Plain English Summary |
Economic analyses are increasingly being used to inform technology adoption and reimbursement decisions in health care in the UK and in other countries. An important aspect of such decision making in the UK is the National Institute for Health & Clinical Excellence (NICE) which has economic analysis as a highly integrated component of its technology appraisal process. This is indicated by: -the stated remit of NICE being to consider cost-effectiveness, -the nature of the assessment reports commissioned specifically for NICE, and -the composition of the Appraisals Committee. For every technology they consider, NICE commissions an independent economic analysis undertaken specifically for their purposes. In addition, senior and experienced health economists sit as permanent members of the Appraisal Committee. Thus, it should be no surprise that recent research suggests that economic evaluation evidence is central to the final determinations reached by the NICE Appraisal Committee (Bryan et al, 2007; Williams et al, forthcoming). The position of influence held by economic analyses emphasises the importance of methodological rigour. NICE has a methodology guide and a 'reference case', and thus is highly proscriptive in terms of the approach to economic analysis that it expects to see in work it commissions. One aspect of the NICE reference case concerns the characterisation of uncertainty and the explicit instruction to use probabilistic sensitivity analysis (PSA) to achieve this. A recent paper, co-authored by an impressive team of health economists (Claxton et al, 2005) argues strongly in support of the NICE reference case in relation to PSA, arguing that it should not be viewed as an 'optional extra' but that it is central to addressing the decision problems tackled by NICE. |
Abstract: |
Our starting point is that an appropriate characterisation of uncertainty is an essential component in an economic analysis of a health care technology. Further, we take the view that PSA conducted to a high standard can achieve the objective of characterising parameter uncertainty in most models developed for NICE. However, it is unclear whether good practice in PSA is being adopted in such analyses, and the influence of PSA on NICE decision-making is unknown. Thus, we propose to address the following research questions. a) How do we define good practice in sensitivity analysis in general and PSA in particular? b) To what extent is good practice adhered to in economic evaluations undertaken for NICE over recent years? c) What views do policy makers have on the PSA approach and what use is made of PSA in policy decision making? d) What policy impact does PSA have in the context of NICE? The National Coordinating Centre for HTA commissioned this technology assessment report on behalf of the NIHR Methodology programme. |
NRR* number, if applicable: |
(*National Research Register) |
Project Protocol: |
Project protocol not available |
URL of this page: |
http://www.hta.ac.uk/1673 |
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