12.04.2013

Critique on lower NICE threshold research

Hi everyone,

sitting here on my desk with a typical December cold, I came across this critique from the OHE of something that gives me even more headaches when reading it. I can't resist giving my 5 cents to it. Seems like Claxton and colleagues have proposed a new NICE threshold of £12,936 ... wooooow and how accurate! I am amazed how politely and scientific the OHE responded to that. My critique is much simpler and less kind: total rubbish!
With all respect for the academic credentials and experience of this group, but this tells me that someone has not understood the bigger things in life that are far more complex than putting forward such a silly paper (and number). I recommend reading a bit of Friedrich August von Hayek's key papers: "The pretence of knowledge" and "The theory of complex phenomena" before engaging in another round of "scientific" threshold analysis: Medicine is not physics, decision making about factors that affect health, physical well being and perceived quality of life etc. do not fit, and should not be decided based on, a foolish formula, full stop.

A good evening to everyone
Regards
Ulf

2 comments:

Anonymous said...

Sounds like Ulf's comment spells out the difference between market access and health economics. Interestingly a separate Ulf post referenced NICE's influential position. NICE of course uses a (bespoke) formula driven calculation of cost-effectiveness. So which way is it Ulf? NICE is great when high thresholds permit expensive modern drugs to be used. Consequential opportunity cost effects create queues for joint replacement ops, diabetics continual glucose sensors are denied, inadequate availability of community mental health nurses... Or vice versa.

ustaginnus@hotmail.com said...

Thanks for the comment, of course there are opportunity cost, always, and they are important to consider, nothing to argue with. But if you read my comments and opinions you will notice that I don't care about high or low thresholds.. the whole threshold "business" the way it is done doesn't work and makes no sense