Suppose you want to show that something has been harmful. There are three things you need. 1) Evidence of evidence causeSome changes or differences that can lead to damage, 2) damageThe essence and scale, 3) evidence of statistics association Between causes and damage. no way Recent papers published Lancet makes a bold claim that good recommendations harm. But without any of the three mentioned here.
I wanted to slide this paper. But last week, Anita Charles Worth (Fantastic man) cited research of all seriousness during the General Assembly in Bristol’s HESG. So we are.
This blog post is based on a simple premise described above. The author has no evidence to consider such claims on the effects of good decisions. I will deal with the three evidence of need. But first, a simple summary of analysis.
NACI et al (2025)
Let’s be clear: This paper does not intend to test a new hypothesis or to reflect light on the previously hidden truth. Rather, it represents the continuous campaign to reduce the cost -efficiency threshold of the varnish. The discussion section creates this ordinary cartoon style, such as “I am so smart and so hard and I don’t have time to say how true.”
The analysis itself is very clean and simple. In short, there are two steps.
First, the researchers have been looking at QEALY (ICER), which NICE has been approved for new medicines in recent years. These tend to belong to the specified threshold of Nice per Qay. The author then compares these ICERS with 15,000 pounds per QALY as a productivity estimates of NHS. Thus, drugs approved at £ 15,000 per QALY are assumed to harm the use, and the author estimates this for average patients taking each newly approved drug.
Second, the author expands this due to the population health effect by multiplying the actual evidence of the total number of patients prescribed by the effect of the patient (commonly damaged).
This is how we end up with the title that the approved drug has created 3.75 million qalys. However, the use of funds would have created 5 million QALYS, so good approval caused 1.2 million qalys.
cause
The source of the damage proposed by the author is a great approval, but they are not directly harmful. The author implicitly assumes the following mechanisms:
- Approves good medicine
- The NHS Commissioner supports the provisions
- NHS clinical trials are prescribed
- NHS commissioner reduces other expenses
In this study, researchers observe only 1 and 30.
The authors observe Nice’s approval by arguing that they live in a world that approves this medicine, not time or space. Researchers use evidence for prescriptions, which are the most innovative contributions of this study.
The most important part of the mechanism (the mechanism that can actually cause damage) is four stages. In terms of spending, we do not know what it happens when NICE approves medicine. Therefore, the entire study depends on the author’s assumption that NHS pays the price at a good price for each drug.It’s definitely not true) And the members will immediately reduce spending with this amount alone (Also not true). Regardless of what you believe in it, we can definitely agree that this is not a claim based on evidence.
In short, researchers argue that good approval is to reduce spending on those other than the approved drugs, and to reduce spending on approved medicines without attempting to observe the facts.
damage
The damage that Nice is applied is estimated from the point of view of QALYS or rather Qalys. I am not qualified to harm the cost of opportunity.
This study does not use actual evidence for QALYS. We do not know about or after good approval or after good approval or about the means of qalys. There is no class.
Everything we have is the assumption that the QALY estimates used for the approval of the relevant NIC and the £ 15,000 of £ 15,000.
In short, there is no evidence of any damage.
Statistics
We have very weak evidence of the cause of the cause and there is no evidence of damage. But for a while, let’s say we have strong evidence of both. The other main requirements are to show the causal relationship between the two. Otherwise, we can see a fake correlation.
What do researchers give us? The answer is Absolutely nothing: Not even the hint of attempts to show causal relationships. Even if we spend a lot of money on each new medicine and know exactly the QALY gain related to them, even if we are 100% convinced, we have no idea of the QALY effect of such investments.
But what about that £ 15,000? Perhaps, it has much less evidence than the £ 20-30,000 range of Nice, which has been confirmed at least based on historical ness decisions. £ 15,000QALY limit cost‘In NHS, these estimates come from the historical regional differences of total expenditures, not the budget allocation decision due to the approval of a new medicine. There is there There is no lack of concern The key point here is that the key point here is that the author of this study is not derived in the same context as the author insisted on causal relationships.
What is it now?
This study can be tremendously influential. They provide convenient and nominal evidence -based excuses to reduce specific types of spending. Therefore, they guarantee intense investigations.
There are other things I want to see more than three things I considered in this blog post, including clear expressions of mechanisms of causality, time identification and exclusion in alternative explanations. I will leave all criticisms of paper to others.
Of course, I can’t express the researchers’ claims. There is no evidence in any way now. But I recommend you to consider your instincts and bring common sense where you lack evidence. Do you think NICE’s health technology evaluation work harms? My transfer is that both NIC, NHS commissioners, and NHS clinical trials tend to work hard to make a decision to achieve the best results for patients. This study argues that they are all consistently failed.
None of these says that this kind of research is worth it. As described in this blog post, there are many things to understand to assess the health effects of expenditure decisions and start somewhere. But this paper should be regarded for what it is and the weakly designated research of researchers who do not consider the flaws. It is a disadvantage that it is convenient to ignore policymakers.
One day, we will be able to know the truth about these things and make a kind of claim that the authors of this study want to make. But if your claim prefers what is based on evidence, you can safely ignore this paper.
