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REFLECTIONS ON THE NICE DECISION TO REJECT PATIENT PRODUCTION LOSSES

Part of: Special Collection - Methods

Published online by Cambridge University Press:  20 November 2017

James Shearer ,
Sarah Byford  and
Steve Birch
James Shearer
Affiliation:
King's Health Economics, King's College Londonjames.shearer@kcl.ac.uk
Sarah Byford
Affiliation:
King's Health Economics, King's College London
Steve Birch
Affiliation:
Centre for Health Economics and Policy Analysis (CHEPA) McMaster University
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Abstract

Objectives: Patient production losses occur when individuals’ capacities to work, whether paid or unpaid, are impaired by illness, treatment, disability, or death. There is controversy about whether and how to include patient production losses in economic evaluations in health care. Patient production losses have not previously been considered when evaluating medications for reimbursement under the U.K. National Health Service. Proposals for value-based assessment of health technologies in the United Kingdom created renewed interest in whether and how to include costs from a wider societal perspective, such as patient production losses, within economic evaluation of healthcare interventions.

Methods: A narrative review was undertaken of theoretical, ethical, and policy issues that might inform decisions that involve the normative question of whether or not to include patient production losses in economic evaluation.

Results: It seems difficult to reconcile the implications of including patient production losses with the objectives of a healthcare system dedicated to providing universal healthcare coverage without regard to patients’ ability to pay.

Conclusions: Tax payer funded healthcare systems may legitimately adopt maximands other than health gain, but these will be at the opportunity cost of less than maximum health gains.

Keywords

Production lossesEconomic evaluationHealth policy
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 6 , 2017 , pp. 638 - 643
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

1. NICE. Guide to the methods of technology appraisal. London: National Institute for Health and Clinical Excellence; 2013.Google Scholar
2. Garau, M, Shah, K, Sharm, P, Towse, A. Is the link between health and wealth considered in decisionmaking? Results from a qualitative study. Int J Technol Assess Health Care. 2016;31:1–8.Google Scholar
3. Krol, M, Papenburg, J, Koopmmanschap, M, Brouwer, W. Do productivity costs matter? The impact of inlcuding productivity costs on the incremental costs of interventions targetted at depressive disorders. PharmacoEconomics. 2011;29:601–619.CrossRefGoogle Scholar
4. Brouwer, W, Rutten, F, Koopmanschap, M. Costing in economic evaluations. In: Drummond, C, McGuire, A, eds. Economic evaluation in health care: Merging theory with practice. Oxford: Oxford University Press; 2001:68–93.CrossRefGoogle Scholar
5. Drummond, M, Sculpher, M, Torrance, G, O'Brien, B, Stoddart, G. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 2005.CrossRefGoogle Scholar
6. Sculpher, M. The role and estimation of productivity costs in economic evaluation In: Drummond, M, McGuire, A, eds. Economic evaluation in health care: merging theory with practice. Oxford: Oxford University Press; 2001:94–112.CrossRefGoogle Scholar
7. Olsen, J, Richardson, J. Production gains from health care: What should be included in cost-effectiveness analysis. Soc Sci Med. 1999;49:17–26.CrossRefGoogle Scholar
8. Luce, B, Manning, W, Siegel, J, Lipscomb, J. Estimating costs in cost-effectiveness analysis. In: Gold, M, Siegel, J, Russell, L, Weinstein, M, eds. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996:176–213.CrossRefGoogle Scholar
9. Lensberg, B, Drummond, M, Danchenko, N, Despiegel, N, Francois, C. Challenges in measuring and valuing productivity costs, and their relevance in mood disorders. Clinicoecon Outcomes Res. 2013;5:565–573.CrossRefGoogle ScholarPubMed
10. Zhang, W, Bansback, N, Anis, A. Measuring and valuing productivity loss due to poor health: A critical review. Soc Sci Med. 2011;72:185–192.CrossRefGoogle ScholarPubMed
11. Herrero, C, Moreno-Ternero, J. Estimating production costs in the economic evaluation of health-care programs. Health Econ. 2009;18:21–35.CrossRefGoogle ScholarPubMed
12. Brouwer, W, Koopmanscahp, M, Rutten, F. Productivity costs measurement through quality of life? A response to the recommendation of the Washington Panel. Health Econ. 1997;6:253–259.3.0.CO;2-6>CrossRefGoogle Scholar
13. Koopmanschap, M, Rutten, FFH, Vanineveld, B, Vanroijen, L. The friction cost method for measuring indirect costs of disease. J Health Econ. 1995;14:171–189.CrossRefGoogle ScholarPubMed
14. Kigozi, J, Jowett, S, Lewis, M, Barton, P, Coast, J. Estimating productivity costs using the friction cost approach in practice: a systematic review. Eur J Health Econ. 2016;17:31–44.CrossRefGoogle ScholarPubMed
15. Morris, S, Devlin, N, Parkin, D, Spencer, A. Economic analysis in health care. 2nd ed. Chichester: Wiley; 2012.Google Scholar
16. Williams, A. Cochrane lecture. All cost effective treatments should be free. . . or, how Archie Cochrane changed my life! J Epidemiol Community Health. 1997;51:116–120.CrossRefGoogle ScholarPubMed
17. Richardson, J. Economic assessment of health care: Theory and practice. Aust Econ Rev. 1991;24:4–21.CrossRefGoogle Scholar
18. Office for National Statistics. Annual survey of hours and earnings: 2016 provisional results. 2016. https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/earningsandworkinghours/bulletins/annualsurveyofhoursandearnings/2016provisionalresults (accessed February 25, 2017).Google Scholar
19. Claxton, K, Sculpher, M, Palmer, S, Culyer, A. Causes for concern: Is NICE failing to uphold its responsibilities to all NHS patients? Health Econ. 2015;24:1–7.CrossRefGoogle ScholarPubMed
20. Claxton, K, Walker, S, Palmer, S, Sculpher, M. Appropriate perspectives for health care decisions. York: Centre for Health Economics, 2010; Paper 54.Google Scholar
21. Mason, H, Jones-Lee, M, Donaldson, C. Modelling the monetary value of a QALY: A new approach based on UK data. Health Econ. 2009;18:933–950.CrossRefGoogle ScholarPubMed
22. McKie, J, Richardson, J. The rule of rescue. Soc Sci Med. 2003;56:2407–2419.CrossRefGoogle ScholarPubMed
23. Arrow, K. Uncertainty and the welfare economics of medical care. Am Econ Rev. 1963;53:941–973.Google Scholar
24. Brouwer, W, Culyer, A, van Exel, N, Rutten, F. Welfarism vs. extra-welfarism. J Health Econ. 2008;27:325–338.CrossRefGoogle ScholarPubMed
25. Gerard, K, Mooney, G. QALY league tables: Handle with care. Health Econ. 1993;2:59–64.CrossRefGoogle ScholarPubMed
26. Gold, M, Siegel, J, Russell, L, Weinstein, M. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.CrossRefGoogle ScholarPubMed
27. Klein, R. The new politics of the NHS. 7th ed. London: Radcliffe Publishing; 2013.Google Scholar
28. Department of Health. The NHS Constitution for England. London: Department of Health; 2013.Google Scholar
29. Gottret, P, Schieber, G. Health financing revisited: A practitioner's guide. Washington DC: The World Bank; 2006.CrossRefGoogle Scholar
30. Donaldson, C, Gerard, K. Economic of health care financing: The visible hand. 2nd ed. Basingstoke: Palgrave Macmillan; 2005.CrossRefGoogle Scholar
31. Layte, R, Nolan, A. Income-related inequity in the use of GP services by children: A comparison of Ireland and Scotland. Eur J Health Econ. 2015;16:489–506.CrossRefGoogle ScholarPubMed
32. Paulden, M. Recent amendments to NICE's value-based assessment of health technologies: Implicitly inequitable? Expert Rev Pharmacoecon Outcomes Res. 2017;17:239–242.CrossRefGoogle ScholarPubMed
33. Walker, S, Griffin, S, Claxton, K, Palmer, S, Sculpher, M. Appropriate perspectives for health care decisions. In: Curtis, L, ed. Unit costs of health and social care 2012. Canterbury: Personal Social Services Research Unit; 2012:8–11.Google Scholar
34. Linley, W, Hughes, D. Societal views on NICE, cancer drugs fund and value based fundig criteria for prioritising medicines: A cross-sectional survey of 4118 adults in Great Britain. Health Econ. 2013;22:948–964.CrossRefGoogle Scholar