Is the National Institute for Health and Care Excellence (NICE) in England more ‘innovation-friendly’ than the Federal Joint Committee (G-BA) in Germany?

Objectives: Our study explores whether, and how, different methodological choices are associated with different health technology assessment (HTA) outcomes. We focus on the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) in Germany and the National Institute for Health and Care Excellenc...

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Hauptverfasser: Schäfer, Ramon (VerfasserIn) , Schlander, Michael (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 30 Dec 2018
In: Expert review of pharmacoeconomics and outcomes research
Year: 2019, Jahrgang: 19, Heft: 4, Pages: 453-462
ISSN:1744-8379
DOI:10.1080/14737167.2019.1559732
Online-Zugang:Verlag, Volltext: https://doi.org/10.1080/14737167.2019.1559732
Verlag: https://doi.org/10.1080/14737167.2019.1559732
Volltext
Verfasserangaben:Ramon Schaefer & Michael Schlander

MARC

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520 |a Objectives: Our study explores whether, and how, different methodological choices are associated with different health technology assessment (HTA) outcomes. We focus on the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) in Germany and the National Institute for Health and Care Excellence (NICE) in England. Both agencies may be considered as exemplars for the application of the principles of evidence-based medicine and the logic of cost-effectiveness, respectively.Methods: We extracted data from all publically available G-BA appraisals until April 2015, as well as all NICE single technology appraisals completed during this period. We compared HTA results for matched condition-intervention pairs by G-BA and NICE, and explored other factors including therapeutic area, clinical effectiveness and cost-effectiveness.Results: NICE issued guidance for 88 technologies (125 subgroups) and recommended 67/88 technologies (99/125 subgroups). G-BA completed 105 appraisals (226 subgroups) and determined additional benefit for 64/105 appraisals (90/226 subgroups). We identified 37 matched pairs; for 24/37 drugs, evaluations diverged. NICE recommended 78% (29/37) of technologies appraised, whereas G-BA confirmed additional benefit for 57% (21/37) only (p < 0.05).Conclusions: NICE evaluates new drugs more favorably than G-BA. However, our analysis suggests differences by therapeutic area. Results indicate that different methods are associated with systematic differences in HTA outcomes. 
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