Country/Region: England & Wales
Submission Guidelines

Guide to the Methods of Technology Appraisals (April 2013)

Methods guide addedum: cost comparison methods

Submission Guidelines Source:

National Institute for Health and Care Excellence (NICE)

Additional Information:

Guide to the processes of technology appraisal

Interim Process and Methods of the Highly Specialised Technologies Programme

Information up to date as of Wednesday, May 27, 2020

Submission Guidelines Key Features:

Key Features:  
Title and year of the document
Guide to the Methods of Technology Appraisals (April 2013)  
Affiliation of authors
National Insititue for Health and Care Excellence (NICE) 
Purpose of the document
To provide an overview of the principles and methods of health technology assessment and appraisal within the context of the NICE appraisal process. It describes key principles of appraisal methodology and is a guide for all organisations considering submitting evidence to the technology appraisal programme of the Institute. 
Standard reporting format included
Yes, template available here: 
Target audience of funding/ author's interests
All organizations considering submitting evidence to the Technology Appraisal Program of the Institute.  
For the reference case, the perspective on outcomes should be all direct health effects, whether for patients or, when relevant, carers.
The perspective on costs is National Health Service (NHS) and Personal Social Services (PSS) 
Licensed indication 
Target population
Must be clearly described 
Subgroup analysis
Subgroup analysis should be clearly justified 
Choice of comparator
Relevant comparators for the technology being appraised are those routinely used in the NHS, and therapies regarded as best practice when this differs from routine practice.  Defined in scoping process.  
Time horizon
The time horizon for estimating clinical and cost effectiveness should be sufficiently long to reflect all important differences in costs or outcomes between the technologies being compared. 
Assumptions required
Must be clearly described and justified 
Preferred analytical technique
For the reference case, cost–utility analysis is the preferred form of economic evaluation. 
Costs to be included
Costs should relate to NHS and PSS resources  
Source of costs
National costs relevant to the NHS and PSS 
Systematic review of evidences
Preference for effectiveness over efficacy
Preferred outcome measure
Preferred method to derive utility
The measurement of changes in health-related quality of life should be reported directly from patients and the utility of these changes should be based on public preferences using a choice-based method. The EQ-5D is the preferred measure of health-related quality of life in adults 
Equity issues stated
Discounting costs
Base: 3.5%; SA: 1.5%  
Discounting outcomes
Base: 3.5%; SA: 1.5%  
Sensitivity analysis-parameters and range
All inputs used in the analysis will be estimated with a degree of imprecision. Appropriate ways of presenting uncertainty in cost-effectiveness data parameter uncertainty include confidence ellipses and scatter-plots on the cost-effectiveness plane (when the comparison is restricted to two alternatives) and cost-effectiveness acceptability curves. The presentation of cost-effectiveness acceptability curves should include a representation and explanation of the cost-effectiveness acceptability frontier. 
Sensitivity analysis-methods
Probabilistic and deterministic SA 
Presenting results
All data used to estimate clinical and cost effectiveness should be presented clearly in tabular form and include details of data sources. 
Incremental analysis
Total costs vs effectiveness (cost/effectiveness ratio)
Portability of results (Generalizability)
In NHS context 
Financial impact analysis
Yes, estimates of net NHS (and PSS, when appropriate) costs of the expected resource impact should be provided to allow effective national and local financial planning. The cost should be disaggregated by appropriate generic organization (NHS, PSS, hospital, primary care) and budgetary categories (for example, drugs, staffing, consumables or capital).  
Mandatory or recommended or voluntary

Acknowledgement: Dalia Dawoud, MSc, PhD, Scientific Adviser, NICE and Caroline Bregman, MSc, Technical Analyst, NICE, United Kingdom

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