Modelling the cost effectiveness of alcohol interventions- methodological hurdles

Over the years, NICE has developed a widely recognised reputation based on the robustness of the methodology it applies in the appraisal of clinical interventions. However, in 2005 it also acquired the remit to produce guidelines for public health interventions.² Through its Centre for Guidelines (CfG), NICE makes recommendations for England based on a thorough review of what is known from research and practice about the effectiveness and cost effectiveness of interventions and broader programmes.^{3, 7}

Although the value of economic evaluation as a tool to determine value for money is hardly in doubt, actual implementation in the context of public health interventions presents a unique challenge. This is because the applied methods were originally developed for constructing clinical guidelines and are based on the principles of evidence-based medicine (EBM),⁴ rather than the relatively newer concept of evidence-based public health. Cost-effectiveness analysis of public health interventions is made difficult by the breadth of the evidence base for such interventions, different analytic levels of possible explanations, and length of the causal chain between interventions and the desired public health outcomes.²

To manage these difficulties, NICE adopts a ‘social determinants and health inequalities’ approach when designing public health guidelines.³ Furthermore, the framework within which such guidelines are developed ensures the multiple analytical levels of explanation for an observed effect are accounted for, and that four specific vectors (population, environment, society and organisations) are used to articulate the mechanisms of cause and interventions.³

Cogora’s Senior Insight & Market Access Analyst, Ejike Nwokoro, attended a recent meeting of a NICE Public Health Advisory Committee (PHAC) which further illustrated the adaptation of economic modelling approaches for public health interventions. As part of the development of a new NICE guideline, the meeting participants discussed the effectiveness and economic evaluation of various school-based alcohol interventions (targeting children and young people aged between 11 and 18 years). ⁶

Click here for more on the proposed economic modelling approaches.

Cogora sits at the heart of a highly engaged community of over 220,000 healthcare professionals. Our Insight & Market Access division combines HEOR expertise with an in-depth knowledge of reimbursement structures and requirements to provide solutions that maximise ROI for our clients’ products.

For more information on our HEOR capabilities and offerings please contact:
Ejike Nwokoro, MD MPH
Senior Insight & Market Access Analyst
E: [email protected]
T: +44 (0)20 7214 0529