The NICE cost-effectiveness thresholds
To assess cost-effectiveness, NICE integrates the Quality-adjusted life years (QALY) score with the price of treatment using the incremental cost-effectiveness ratio (ICER). This represents the change in costs in relation to the change in health status. The result is a ‘cost per QALY’ figure.
NICE has stated that it uses a “threshold range” to determine whether the cost per QALY of a treatment offers value for money. It provides its advisory bodies with a framework for decision-making as follows:
- Below an ICER of £20,000 per QALY, judgements about the acceptability of a technology as an effective use of NHS resources are based primarily on the cost effectiveness estimate.
- Above an ICER of £20,000 per QALY, judgments about the acceptability of the technology as an effective use of NHS resources are more likely to make more explicit reference to factors including the degree of uncertainty of the ICER, the innovative nature of the technology, the particular features of the condition and population receiving the technology, and (where appropriate) the wider societal costs and benefits.
- Above an ICER of £30,000 per QALY the case for supporting the technology on these factors has to be increasingly strong. Recommendations for interventions costing more than £20–£30,000 per QALY must be explained
The costs of road traffic injuries
US D of T UK D for T Slight/minor 0.002 0.008 Moderate 0.0155 Serious 0.0575 0.11 Severe 0.1875 Critical 0.7625
- National Institute for Health and Clinical Excellence, The House of Commons Health Committee, First Report of Session 2007–08, 17 December 2007
- Treatment of the Economic Value of a Statistical Life in Departmental Analyses, Office of the Secretary of Transportation, 2008
- 2005 Valuation of the Benefits of Prevention of Road Accidents and Casualties, Department for Transport, January 2007