Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T06:11:04.587Z Has data issue: false hasContentIssue false

NICE's social value judgements about equity in health and health care

Published online by Cambridge University Press:  01 May 2012

Koonal K. Shah*
Affiliation:
Office of Health Economics, London, UK School of Health and Related Research, University of Sheffield, Sheffield, UK
Richard Cookson
Affiliation:
Centre for Health Economics, University of York, York, UK
Anthony J. Culyer
Affiliation:
Centre for Health Economics, University of York, York, UK Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
Peter Littlejohns
Affiliation:
Division of Health and Social Research, King's College London, London, UK
*
*Correspondence to: Koonal K. Shah, Office of Health Economics, 7th floor Southside, 105 Victoria Street, London SW1E 6QT, UK. E-mail: [email protected]

Abstract

The National Institute for Health and Clinical Excellence (NICE) routinely publishes details of the evidence and reasoning underpinning its recommendations, including its social value judgements (SVJs). To date, however, NICE's SVJs relating to equity in the distribution of health and health care have been less specific and systematic than those relating to cost-effectiveness in the pursuit of improved total population health. NICE takes a pragmatic, case-based approach to developing its principles of SVJ, drawing on the cumulative experience of its advisory bodies in making decisions that command respect among its broad range of stakeholders. This paper aims to describe the SVJs about equity in health and health care that NICE has hitherto used to guide its decision making. To do this, we review both the general SVJs reported in NICE guidance on methodology and the case-specific SVJs reported in NICE guidance about particular health care technologies and public health interventions.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Avorn, J. (1984), ‘Benefit and cost analysis in geriatric care – turning age discrimination into health policy’, New England Journal of Medicine, 310: 129130.CrossRefGoogle ScholarPubMed
Baker, R., Bateman, I., Donaldson, C., Jones-Lee, M., Lancsar, E., Loomes, G., Mason, H., Odejar, M., Pinto-Prades, J.L., Robinson, A., Ryan, M., Shackley, P., Smith, R., Sugden, R., Wildman, J. (2010), ‘Weighting and valuing quality-adjusted life-years using stated preference methods: preliminary results from the social value of a QALY project’, Health Technology Assessment, 14(27): 1162.Google Scholar
Cookson, R., Tsuchiya, A.McCabe, C. (2008), ‘Public resource allocation and the rule of rescue’, Journal of Medical Ethics, 34: 540544.Google Scholar
Culyer, A. J. (1995), ‘Need: the idea won't do – but we still need it’, Social Science & Medicine, 40(6): 727730.Google Scholar
Culyer, A. J. (2005), ‘Involving stakeholders in healthcare decisions – the experience of the National Institute for Health and Clinical Excellence (NICE) in England and Wales’, Healthcare Quarterly, 8: 5660.Google Scholar
Culyer, A. J.Lomas, J. (2006), ‘Deliberative processes and evidence-informed decision-making in health care – do they work and how might we know?’, Evidence and Policy, 2: 357371.Google Scholar
Daniels, N. (2000), ‘Accountability for reasonableness’, British Medical Journal, 321: 13001301.Google Scholar
Daniels, N.Sabin, J. E. (2008), ‘Accountability for reasonableness: an update’, British Medical Journal, 337: a1850.Google Scholar
Department of Health (2010), A New Value-Based Approach to the Pricing of Branded Medicines – a Consultation, London: Department of Health.Google Scholar
Dolan, P., Edlin, R., Tsuchiya, A., Armitage, C., Hukin, A., Brazier, J., Ibbotson, R., Bryan, S., Eiser, D., Olsen, J.A. (2008), The Relative Societal Value of Health Gains to Different Beneficiaries: Final Report to NICE, London: National Institute for Health and Clinical Excellence.Google Scholar
Graham, H.Kelly, M. P. (2004), Health Inequalities: Concepts, Frameworks and Policy, London: Health Development Agency, Retrieved from http://www.nice.org.uk/page.aspx?o=502453.Google Scholar
Grimley-Evans, J. (1992), ‘Quality of Life Assessments and Elderly People’, in A. Hopkins (ed.), Measures of the Quality of Life and the Uses to Which such Measures may be put, London: Royal College of Physicians.Google Scholar
Harris, J. (2005), ‘It's not NICE to discriminate’, Journal of Medical Ethics, 31: 373375.Google Scholar
Hoover, D. R., Crystal, S., Kumar, R., Sambamoorthi, U.Cantor, J. C. (2002), ‘Medical expenditures during the last year of life: findings from the 1992–1996 medicare current beneficiary survey’, Health Services Research, 37: 16251642.Google Scholar
Jonsen, A. R.Toulmin, S. (1988), The Abuse of Casuistry: A History of Moral Reasoning, Berkeley: University of California Press.Google Scholar
Kennedy, I. (2009), Appraising the value of innovation and other benefits: a short study for NICE, London: NICE.Google Scholar
Littlejohns, P.Rawlins, M. (eds) (2009), Patients, the public and priorities in healthcare, Oxon: Radcliffe Publishing.Google Scholar
Longson, C.Littlejohns, P. (2009), Update Report on the Application of the ‘End-of-Life’ Supplementary Advice in Health Technology Appraisals, London: NICE.Google Scholar
McKie, J.Richardson, J. (2003), ‘The rule of rescue’, Social Science & Medicine, 56(12): 24072419.CrossRefGoogle ScholarPubMed
National Health Service (NHS) (2005), Directions and Consolidating Directions to the National Institute for Health and Clinical Excellence 2005, London: NHS, Retrieved from http://www.nice.org.uk/niceMedia/pdf/DirectionFromSecretaryOfState2005.pdfGoogle Scholar
National Institute for Health and Clinical Excellence (NICE) (2001), Guidance on the use of Riluzole (Rilutek) for the Treatment of Motor Neurone Disease, London: NICE.Google Scholar
NICE (2002), Guidance on the use of Trastuzumab for the Treatment of Advanced Breast Cancer, London: NICE.Google Scholar
NICE (2003), Guide to the Methods of Technology Appraisal, London: NICE.Google Scholar
NICE (2006a), Final Appraisal Determination: Pemetrexed Disodium for the Treatment of Malignant Pleural Mesothelioma, London: NICE.Google Scholar
NICE (2006b), Appraisal of Pemetrexed Disodium for the Treatment of Malignant Pleural Mesothelioma: Decision of the Panel, London: NICE.Google Scholar
NICE (2007), Omalizumab for Severe Persistent Allergic Asthma, London: NICE.Google Scholar
NICE (2008a), Social Value Judgements: Principles for the Development of NICE Guidance, 2nd edition, London: NICE.Google Scholar
NICE (2008b), Guide to the Methods of Technology Appraisal (second edition), London: NICE.Google Scholar
NICE (2008c), Alendronate, Etidronate, Risedronate, Raloxifene and Strontium Ranelate for the Primary Prevention of Osteoporotic Fragility Fractures in Postmenopausal Women, London: NICE.Google Scholar
NICE (2008d), Pemetrexed for the Treatment of Malignant Pleural Mesothelioma, London: NICE.Google Scholar
NICE (2008e), Appraisal of Pemetrexed for the Treatment of Malignant Pleural Mesothelioma: Decision of the Panel, London: NICE.Google Scholar
NICE (2008f), Smoking Cessation Services in Primary Care, Pharmacies, Local Authorities and Workplaces, Particularly for Manual Working Groups, Pregnant Women and Hard to Reach Communities, London: NICE.Google Scholar
NICE (2009a), Methods for the Development of NICE Public Health Guidance (second edition), London: NICE.Google Scholar
NICE (2009b), Appraising Life-Extending, end of Life Treatments, London: NICE, Retrieved from http://www.nice.org.uk/media/E4A/79/SupplementaryAdviceTACEoL.pdf [25 March 2011].Google Scholar
NICE (2009c), Bevacizumab (first-line), Sorafenib (first- and second-line), Sunitinib (second-line) and Temsirolimus (first-line) for the Treatment of Advanced and/or Metastatic renal Cell Carcinoma, London: NICE.Google Scholar
NICE (2010), Human Growth Hormone (Somatropin) for the Treatment of Growth Failure in Children, London: NICE.Google Scholar
Paulden, M., Culyer, A. J. (2010), ‘Does Cost-effectiveness Analysis Discriminate Against Patients with Short Life Expectancy? Matters of Logic and Matters of Context’. CHE Research Paper 55. York: Centre for Health Economics, University of York.Google Scholar
Rawlins, M. (2004), Scientific and Social Value Judgements, London: NICE.Google Scholar
Rawlins, M., Barnett, D.Stevens, A. (2010), ‘Pharmacoeconomics: NICE's approach to decision-making’, British Journal of Clinical Pharmacology, 70(3): 346349.Google Scholar
Rawlins, M. D.Culyer, A. J. (2004), ‘National institute for clinical excellence and its value judgements’, British Medical Journal, 329: 224227.Google Scholar
Shah, K. K. (2009), ‘Severity of illness and priority setting in healthcare: a review of the literature’, Health Policy, 93: 7784.Google Scholar
Stevens, A., Doyle, N., Littlejohns, P., Docherty, M. (2012), ‘National institute for health and clinical excellence appraisal and ageism’, Journal of Medical Ethics, doi: 10.1136/medethics-2011-100129.Google Scholar