Interpreting small differences in health utilities and incremental QALYs

NICE’s Research Team (part of the Science, Evidence and Analytics (SEA) directorate) is currently working on a Wellcome-funded research project on regulation and evaluation of digital mental health technologies (DMHTs). This project has a projected underspend that we have identified could be used to complete a project on challenges for economic evaluation of DMHTs. After discussion with colleagues, we have settled on exploring issues around interpreting small incremental benefits.

Research question: When observed mean overall QALY and/or component parts of health related quality of life (HRQoL) differences between health interventions are small, how should these differences be interpreted?

A report will summarise all phases of the work and be submitted to NICE for review. We will discuss with NICE if the content warrants publication as a TSD but at this stage our expectation is that it would not. Upon acceptance of a final version, the report will be published on the DTSU website.

DSU Report

Interpreting small differences in health utilities and incremental QALYs 

The report outlines the problem of small differences in health utilities and incremental QALYs, standard health economic methods for addressing uncertainty in economic evaluations, 9 case studies of economic evaluations with small QALY gains, and a targetted literature review of four priority areas. The report concludes with 13 recommendations that may be useful when conducting economic evaluations with small differences in health utilities and incremental QALYs based on our findings and discussions with experts in interpreting health economic analyses with small QALY gains.