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Should the Lambda (λ) Remain Silent?

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References

  1. Gafni A, Birch S. Incremental cost-effectiveness ratios (ICERs): the silence of the lambda. Soc Sci Med. 2006;62:2091–100.

    Article  PubMed  Google Scholar 

  2. Culyer A, McCabe C, Briggs A, Claxton K, Buxton M, Akehurst R, et al. Searching for a threshold, not setting one: the role of the National Institute for Health and Clinical Excellence. J Health Serv Res Policy. 2007;12:56–8.

    Article  PubMed  Google Scholar 

  3. Drummond MF, Sculpher MJ, Claxton K, et al. Methods for the economic evaluation of health care programmes. 4th ed. Oxford: Oxford University Press; 2015.

    Google Scholar 

  4. Higgins A, Barnett J, Meads C, et al. Does convenience matter in health care delivery? A systematic review of convenience-based aspects of process utility. Value Health. 2014;17:877–87.

    Article  CAS  PubMed  Google Scholar 

  5. Gray AM, Clarke P, Wolstenholme J, Wordsworth S. Applied methods of cost-effectiveness analysis in health care. New York: Oxford University Press; 2011.

    Google Scholar 

  6. Laupacis A, Feeny D, Detsky AS, Tugwell PX. How attractive does a new technology have to be to warrant adoption and utilization: tentative guidelines for using clinical and economic evaluations. Can Med Assoc J. 1992;146:473–81.

    CAS  Google Scholar 

  7. Hirth RA, Chernew ME, Miller E, Fendrick AM, Weissert WG. Willingness to pay for a quality-adjusted life year: in search of a standard. Med Decis Mak. 2000;20:332–42.

    Article  CAS  Google Scholar 

  8. McCabe C, Claxton K, Culyer AJ. The NICE cost-effectiveness threshold—what it is and what that means. Pharmacoeconomics. 2008;26:733–44.

    Article  PubMed  Google Scholar 

  9. Gyrd-Hansen D. Willingness to pay for a QALY. Health Econ. 2003;12:1049–60.

    Article  PubMed  Google Scholar 

  10. Bobinac A, Van Exel NJ, Rutten FF, et al. Willingness to pay for a quality-adjusted life-year: the individual perspective. Value Health. 2010;13:1046–55.

    Article  PubMed  Google Scholar 

  11. Cleemput I, Neyt M, Thiry N, et al. Using threshold values for cost per quality-adjusted life-year gained in healthcare decisions. Int J Technol Assess. 2011;27:71–6.

    Article  Google Scholar 

  12. Gyrd-Hansen D. Willingness to pay for a QALY—theoretical and methodological issues. Pharmacoeconomics. 2005;23:423–32.

    Article  PubMed  Google Scholar 

  13. Pekarsky B. The new drug reimbursement game: a regulator’s guide to playing and winning. Cham, Switzerland: Springer International Publishing; 2014.

    Google Scholar 

  14. Paulden M, O’Mahony JF, Culyer AJ, et al. Some inconsistencies in NICE’s consideration of social values. Pharmacoeconomics. 2014;32:1043–53.

    Article  PubMed  Google Scholar 

  15. Claxton K, Martin S, Soares M, et al. Methods for the estimation of the National Institute for Health and Care Excellence cost-effectiveness threshold. Health Technol Assess. 2015;19(14):1–504.

    Article  PubMed  Google Scholar 

  16. Schaffer SK, Sussex J, Devlin N, et al. Local health care expenditure plans and their opportunity costs. Health Policy. 2015;119:1237–44.

    Article  Google Scholar 

  17. Committee Pharmaceutical Benefits Advisory. Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee. Canberra: The Australian Government; 2013.

    Google Scholar 

  18. Harris AH, Hill SR, Chin G, et al. The role of value for money in public insurance coverage decisions for drugs in Australia: a retrospective analysis 1994–2004. Med Decis Making. 2008;28:713–22.

    Article  PubMed  Google Scholar 

  19. Australian Government Department of Health. Ruxolitinib, tablets, 5 mg, 15 mg and 20 mg, Jakavi®. July 2013: Public summary document. http://www.pbs.gov.au/info/industry/listing/elements/pbac-meetings/psd/2013-07/ruxolitinib. Accessed 6 Jan 2015.

  20. Australian Government Department of Health. Multicomponent meningococcal group B vaccine, 0.5 mL, injection, prefilled syringe, Bexsero®. November 2013: Public summary document. http://www.pbs.gov.au/info/industry/listing/elements/pbac-meetings/psd/2013-11/meningococcal-vaccine. Accessed 6 Jan 2015.

  21. Australian Government Department of Health. Brentuximab vedotin, injection, 50 mg, Adcetris®. July 2014: Public summary document. http://www.pbs.gov.au/industry/listing/elements/pbac-meetings/psd/2014-07/brentuximab-psd-07-2014.pdf. Accessed 2 Feb 2015.

  22. Taylor RS, Drummond MF, Salkeld G, et al. Inclusion of cost effectiveness in licensing requirements of new drugs: the fourth hurdle. BMJ. 2004;329:972–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. George B, Harris A, Mitchell A. Cost-effectiveness analysis and the consistency of decision making. Evidence from pharmaceutical reimbursement in Australia (1991–1996). Pharmacoeconomics. 2001;19:1103–9.

    Article  CAS  PubMed  Google Scholar 

  24. Eichler HG, Kong SX, Gerth WC, et al. Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge? Value Health. 2004;7:518–28.

    Article  PubMed  Google Scholar 

  25. Birch S, Gafni A. The biggest bang for the buck or bigger bucks for the bang: the fallacy of the cost-effectiveness threshold. J Health Serv Res Policy. 2006;11:46–51.

    Article  PubMed  Google Scholar 

  26. Cleemput I, Neyt M, Thiry N, et al. Threshold values for cost-effectiveness in health care. Brussels: Belgian Health Care Knowledge Centre; 2008.

    Google Scholar 

  27. Deloitte Access Economics (Commissined by Medicines Australia). Access to cancer medicines in Australia. 2013. http://medicinesaustralia.com.au/files/2013/07/Access-to-oncology-medicines-1707-FINALV3.pdf. Accessed 7 Jan 2015.

  28. Claxton K, Briggs A, Buxton MJ, et al. Value based pricing for NHS drugs: an opportunity not to be missed? BMJ. 2008;336:251–4.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Griffin SC, Claxton KP, Palmer SJ, et al. Dangerous omissions: the consequences of ignoring decision uncertainty. Health Econ. 2011;20:212–24.

    Article  PubMed  Google Scholar 

  30. Claxton K. Oft, Vbp: Qed? Health Econ. 2007;16:545–58.

    Article  PubMed  Google Scholar 

  31. Doyal L. The rationing debate: rationing within the NHS should be explicit—the case for. Brit Med J. 1997;314:1114–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Pharmaceutical Management Agency. Making funding decisions. Wellington: Pharmaceutical Management Agency; 2015.

    Google Scholar 

  33. National Institute for Health and Care Excellence (NICE). Consultation paper: value-based assessment of health technologies. London: NICE; 2014.

  34. Goetghebeur MM, Wagner M, Khoury H, et al. Bridging health technology assessment (HTA) and efficient health care decision making with multicriteria decision analysis (MCDA): applying the EVIDEM framework to medicines appraisal. Med Decis Mak. 2012;32:376–88.

    Article  Google Scholar 

  35. Claxton K, Sculpher M, Palmer S, Culyer AJ. Causes for concern: is NICE failing to uphold its responsibilities to all NHS patients? Health Econ. 2015;24:1–7.

    Article  PubMed  Google Scholar 

  36. Coast J. The rationing debate: rationing within the NHS should be explicit—the case against. Brit Med J. 1997;314:1118–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Raftery JP. NICE’s cost-effectiveness range: should it be lowered? Pharmacoeconomics. 2014;32:613–5.

    Article  CAS  PubMed  Google Scholar 

  38. Sculpher M, Claxton K. Real economics needs to reflect real decisions response. Pharmacoeconomics. 2012;30:133–6.

    Article  PubMed  Google Scholar 

  39. Australian Government Department of Health. Sofosbuvir, 400 mg tablet, Sovaldi®. July 2014. Public summary document. http://www.pbs.gov.au/industry/listing/elements/pbac-meetings/psd/2014-07/sofosbuvir-psd-07-2014.pdf. Accessed 10 Sep 2015.

  40. Australian Government Department of Health. Sofosbuvir, 400 mg tablet, Sovaldi®. March 2015. Public smmary document. http://www.pbs.gov.au/industry/listing/elements/pbac-meetings/psd/2015-03/Files/sofosbuvir-psd-march-2015.pdf. Accessed 10 Sep 2015.

  41. Culyer AJ. Equity—some theory and its policy implications. J Med Ethics. 2001;27:275–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. National Institute for Health and Care Excellence (NICE). Guide to the methods of technology appraisal 2013. London: NICE; 2013.

  43. National Institute for Health and Clinical Excellence. NICE response to the first report of session 2007–2008. London: Stationery Office; 2009.

    Google Scholar 

  44. Longworth L, Sculpher MJ, Bojke L, Tosh JC. Bridging the gap between methods research and the needs of policy makers: a review of the research priorities of the National Institute for Health and Clinical Excellence. Int J Technol Assess Health Care. 2011;27:180–7.

    Article  PubMed  Google Scholar 

  45. Barnsley P, Towse A, Karlsberg Schaffer S, Sussex J. Critique of CHE Research Paper 81: methods for the estimation of the NICE cost-effectiveness threshold. 2013. https://www.ohe.org/publications/critique-cheresearch-paper-81-methods-estimation-nice-cost-effectiveness-threshold. Accessed 10 Jan 2015.

  46. Claxton C, Sculpher M. Response to the OHE critique of CHE Research paper 81. 2014. http://www.york.ac.uk/media/che/documents/Response%20to%20the%20OHE%20critique%20of%20CHE%20Research%20paper%2081.pdf. Accessed 4 Mar 2015.

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Acknowledgments

Hossein Haji Ali Afzali, Jonathan Karnon and Mark Sculpher conceptualized the manuscript and prepared the final draft. They share full responsibility for its content. Hossein Haji Ali Afzali is the overall guarantor.

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Correspondence to Hossein Haji Ali Afzali.

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No sources of funding were used to prepare this manuscript.

Conflicts of interest

Hossein Haji Ali Afzali is a member of the ESC of the MSAC. Jonathan Karnon has served as a member of the ESC of the PBAC since 2009. Mark Sculpher has been a member of various NICE advisory committees and was co-author of the University of York’s research on the NHS cost-effectiveness threshold.

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Haji Ali Afzali, H., Karnon, J. & Sculpher, M. Should the Lambda (λ) Remain Silent?. PharmacoEconomics 34, 323–329 (2016). https://doi.org/10.1007/s40273-015-0359-7

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