@robdykedotcom Oops! Just noticed I posted the same link twice 🤦♂️ Here's @NICEComms itself, in response to the York paper: https://t.co/VWuBRHCb12 Other views, from 2007: https://t.co/Qc1ujf3uy6 2014: https://t.co/EsFROJ3M3U and @NHSEngland, just
Second, NICE does not apply equity weights to the QALYs forgone by NHS patients who bear the opportunity cost of its decisions. This fundamental inequity has been recognized for years (e.g. this paper from 2014) but has not yet been addressed by NICE. [3]
Thanks Paul. I agree - NICE needs to be careful with modifiers. They must be accounted for in the opportunity cost, which means some new technologies will be *less* cost-effective than before. Logically, the weighted average threshold across all appraisals
I don't like these 'Modifiers' (among other things). #NICE seems to ignore that every decision to INCLUDE a new treatment into the system has the potential to EXCLUDE other, existing treatments. See this very clever paper by @mikepaulden et al (from 2014):