G-BA and NICE are two influential health technology assessment (HTA) agencies: both have large markets for pharmaceuticals, many countries look to Germany for reference pricing, and NICE decisions are referenced in other agencies’ assessments.
Both agencies review the clinical efficacy of a product against an appropriate comparator. NICE also evaluates the cost-effectiveness of the drug. The main output of a G-BA review is the additional benefit score, while for NICE, it is an incremental cost-effectiveness ratio (ICER).
Because both outcomes are dependent on the clinical efficacy evaluation, we hypothesized that
G-BA’s additional benefit score and NICE’s ICER are inversely related (i.e., as the additional benefit of the drug increases, the ICER decreases, demonstrating greater cost-effectiveness). The choice of comparator and cost-effectiveness model parameters can influence the relationship between additional benefit and ICERs, but the core relationship should remain; in theory drugs that offer greater benefit than their comparators should be more cost-effective and have lower ICERs.
The relationship between NICE and G-BA is useful for manufacturers trying to manage reimbursement in these markets and throughout the world. We examined how G-BA’s additional benefit decisions correlated with NICE’s reimbursement decisions and the drugs’ ICERs.
See our analysis and conclusions in the full research brief.
Original research presented at ISPOR 2015 in Philadelphia.