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'NICE's use of cost-effectiveness as an exemplar of a deliberative process'

Culyer, A.J. (2006) 'NICE's use of cost-effectiveness as an exemplar of a deliberative process'. Health Economics, Policy and Law, 1 (3). pp. 299-318. ISSN 1744-1331

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Abstract

This paper seeks to test 12 conjectures about the predicted use of deliberative processes by applying them to the technology assessment procedures used by the National Institute for Health and Clinical Excellence (NICE) in England and Wales. A deliberative process is one that elicits and combines evidence of different kinds and from different sources in order to develop guidance – in the present case, guidance for a health care system. A deliberative process entails the integration of three kinds of evidence: scientific context-free evidence about the general clinical potential of a technology, scientific context-sensitive evidence about particular evidence in realistic scenarios, and colloquial evidence to fit context-free scientific evidence into a context and to supply the best evidence short of scientific evidence to fill in any relevant gaps. It is shown that NICE's appraisals procedures and, in particular, its approach to cost effectiveness, entail both the weighing of each of these types of evidence and can be seen as rational responses to the 12 conjectures.

Item Type: Article
Institution: The University of York
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 11 Jun 2009 09:46
Last Modified: 11 Jun 2009 09:46
Published Version: http://dx.doi.org/10.1017/S1744133106004026
Status: Published
Publisher: Cambridge University Press
Identification Number: 10.1017/S1744133106004026
URI: http://eprints.whiterose.ac.uk/id/eprint/6217

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