The NCPE conducts health technology assessments of pharmaceutical products for the HSE in Ireland. There are challenges to these assessments including small study sizes, uncertainty around long-term effects and costs, and a lack of head-to-head comparisons. Currently, the patient voice is heard both formally through quality-adjusted life year valuations that measure preferences for health, and informally through patient organizations and political debate. QALYs measure changes in length and quality of life on a unified scale. Ireland has valued health states hypothetically through methods like visual analog scales, ranking, and time trade-off exercises.

1. Dr. Roisin Adams
Mar 2015
National Centre for Pharmacoeconomics
Pharmacoeconomics
Methods and Practical
Applications

2. The NCPE conducts the health
technology assessment (HTA) of
pharmaceutical products for the Health
Service Executive

12. Challenges
 Benefit
Small studies
Single arm (no comparison)
 Adverse Events
 Uncertainty
In relation to lifetime extrapolations
How a drug may be used in Ireland
 Costs
Justification
Additional hidden costs

13. Cathal

14. How is the patient voice heard currently
 Formally
QALY valuations
 Preferences for health measured by society
 Informally
Organisations incl. IPPOSI,
Patient groups
Political debate and election

15. The QALY
 Measures changes in length of life and
HRQoL
 Length of life measured in natural units
(years)
QALY = Length of life x Utility

16. QALY Valuations
 We ask people to make their preferences
in relation to health
 Asking a person to state their preference
(choose) for one option (health state) over
another
E.g. Life A or Life B or Length of time in Life
A or Life B

17. Hypothetical versus Experienced
 Most country valuations have valued
hypothetical health states
Vs.

18. Irish Valuation
 Measure Health
 Value
VAS (Thermometer measure)
Rank health states (from best to worst)
Time Trade Off

19. VAS

20. Ranking

21. EQ-5D
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