The cost-effectiveness of public health interventions examined by NICE from 2011 to 2016

J Public Health (Oxf). 2018 Sep 1;40(3):557-566. doi: 10.1093/pubmed/fdx119.

Abstract

Background: A review of economic evaluations of public health interventions assessed by NICE between 2005 and 2010 found 85% were cost-effective. Owen et al. (The cost-effectiveness of public health interventions. J Public Health 2012;34(1):37-45). With significant pressure on budgets the role of economics in securing funding remains important. This study updates the earlier analysis.

Methods: Economic evaluations carried out between 2011 and 2016 were categorized: cost-utility analysis (CUA), cost-effectiveness analysis (CEA), cost-benefit analysis (CBA) and cost-consequences analysis (CCA). Cost-effectiveness estimates were analysed and compared with Owen et al. (The cost-effectiveness of public health interventions. J Public Health 2012;34(1):37-45).

Results: Of 43 guidelines examined, 23 used CUA for specific interventions yielding 138 base-case incremental cost-effectiveness ratio (ICER) estimates, 11 used CUA for a threshold or 'what if' analysis, 1 used CEA, 3 used CCA, 1 used CBA and CUA and 1 used CEA and CUA, 5 did not require economic modelling. Compared with the earlier period, the median ICER for the 138 estimates was substantially higher (£7843 versus £1053) and there was greater variability (a higher proportion in the later period was cost-saving, but a higher proportion was also over £20 000 per quality adjusted life year).

Conclusions: Nearly two-thirds (63%) of public health interventions assessed were cost-effective. However, increased variability in estimates highlights the importance of assessing cost-effectiveness to ensure good use of scarce resources.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost Savings
  • Cost-Benefit Analysis
  • Health Care Costs
  • Humans
  • Models, Economic
  • Public Health Practice* / economics
  • United Kingdom