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Original Research

Acceptance of health technology assessment submissions with incremental cost-effectiveness ratios above the cost-effectiveness threshold

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Pages 463-476 | Published online: 31 Aug 2015

Figures & data

Figure 1 Summary of methods.

Abbreviations: BNF, British National Formulary; CADTH, Canadian Agency for Drugs and Technologies in Health; HTA, health technology assessment; ICER, incremental cost-effectiveness ratio; MTA, multiple technology assessment; NICE, National Institute for Health and Care Excellence; PBAC, Pharmaceutical Benefits Advisory Committee; SMC, Scottish Medicines Consortium.
Figure 1 Summary of methods.

Table 1 Acceptance rates for total submissions and for submissions with ICERs higher than the threshold (N=679)

Figure 2 HTA submission outcomes by disease area, for total submissions (top, darker bars) and submissions with ICERs higher than the threshold (bottom, lower bars).

Notes: The lower bar in each disease category represents outcomes for submissions with ICERs higher than the agency’s cost-effectiveness threshold ((A) NICE: £30,000; (B) SMC: £30,000; (C) CADTH: CAN$50,000; (D) PBAC: AUS$42,000). Note that the malignant disease and immunosuppression category includes cytotoxic drugs, drugs affecting the immune response, and sex hormones/hormone antagonists in malignant disease.
Abbreviations: ICER, incremental cost-effectiveness ratio; NICE, National Institute for Health and Care Excellence; SMC, Scottish Medicines Consortium; CADTH, Canadian Agency for Drugs and Technologies in Health; PBAC, Pharmaceutical Benefits Advisory Committee.
Figure 2 HTA submission outcomes by disease area, for total submissions (top, darker bars) and submissions with ICERs higher than the threshold (bottom, lower bars).

Figure 3 Funnel plot demonstrating difference in acceptance rates for submissions with ICERs higher than the threshold for different disease areas.

Note: Funnel plot with illustrative 95% confidence intervals.
Abbreviations: CNS, central nervous system; ICER, incremental cost-effectiveness ratio; O and G and UTDs, obstetrics, gynecology, and urinary tract disorders.
Figure 3 Funnel plot demonstrating difference in acceptance rates for submissions with ICERs higher than the threshold for different disease areas.

Table S1 List of all submissions that were accepted with ICERs higher than the threshold, by HTA agency

Table S2 Acceptance of submissions with ICERs higher than the threshold by disease area

Table S3 Chi-square test “Is there evidence that acceptance rates above the accepted thresholds are higher for some therapeutic areas than for others?”