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Reframing NICE's Cost-Effectiveness Threshold: Technical Benchmark or Policy Signal? A Documentary Content Analysis
Hesam Ghiasvand1, Seyran Naghdi2
1Centre for Healthcare and Community Transformation (HCT), Coventry University, United Kingdom.
Summary
The National Institute for Health and Care Excellence (NICE) cost-effectiveness threshold (CET) uplift was framed as a political reform, impacting industrial strategy and health technology assessment (HTA) governance. Debates revealed differing views on economic growth versus population health.
Area of Science:
- Health Economics and Policy
- Health Technology Assessment (HTA)
- Pharmaceutical Policy
Background:
- The National Institute for Health and Care Excellence (NICE) announced a cost-effectiveness threshold (CET) uplift in December 2025.
- This policy change initiated a significant debate among diverse stakeholders regarding its implications.
Purpose of the Study:
- To analyze how various stakeholders framed the NICE CET uplift during the early policy debate phase.
- To understand the multifaceted perspectives on the threshold adjustment beyond technical cost-effectiveness.
Main Methods:
- Qualitative documentary content analysis using the READ framework.
- Purposive sampling of 27 public documents from October 2025 to March 2026.
- Analysis through iterative coding and thematic synthesis across stakeholder groups.
Main Results:
- Government reframed the CET as an industrial policy tool for economic growth and pharmaceutical competitiveness.
- Disagreements arose concerning HTA governance and ministerial influence on threshold setting.
- Stakeholders presented conflicting views on reform consequences: innovation access versus opportunity costs and population health impacts.
- The reform was situated within broader geopolitical and pharmaceutical policy dynamics.
- Contrasting opinions were expressed regarding transparency, consultation, and procedural legitimacy.
Conclusions:
- The NICE threshold uplift was perceived as a politically mediated reform with broad implications.
- Cost-effectiveness thresholds are sites of political, economic, and institutional contestation.
- The debate extended beyond traditional health economic evaluation, influencing industrial strategy, HTA governance, resource allocation, and public trust.
Keywords:
NICEcost-effectiveness thresholdhealth policyhealth technology assessmentopportunity costpharmaceutical policyMore Related Videos
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