Comparing the ICERs in medicine reimbursement submissions to NICE and PBAC—does the presence of an explicit threshold affect the ICER proposed?

Value in Health

8 August 2018 - The English NICE and the Australian PBAC require evidence that a new medicine represents value for money before being publicly funded. NICE has an explicit threshold for cost effectiveness, whereas PBAC does not. 

Wand et al. compared the initial incremental cost-effectiveness ratios (ICERs) presented by manufacturers in matched submissions to each decision-making body, with the aim of exploring the impact of an explicit threshold on these ICERs.

Data were extracted from matched submissions from 2005 to 2015. The ICERs in these submissions were compared within each pair and with respect to a cost-effectiveness threshold.

Fifty-eight pairs of matched submissions were identified. The median difference between the ICERs ($2635/quality-adjusted life year) was significantly greater than zero (Wilcoxon signed-rank test, P = 0.0299), indicating that the proposed ICERs in the submissions to NICE were higher than those in the matched submissions to PBAC.

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Michael Wonder

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Michael Wonder