Searching for cost effectiveness thresholds in the NHS

John Appleby, Nancy Devlin, David Parkin, Martin Buxton, Kalipso Chalkidou

Research output: Contribution to journalArticlepeer-review

69 Citations (Scopus)


The UK's National Institute of Health and Clinical Excellence (NICE) has an explicit cost-effectiveness threshold for deciding whether or not services are to be provided in the National Health Service (NHS), but there is currently little evidence to support the level at which it is set. This study examines whether it is possible to obtain such evidence by examining decision making elsewhere in the NHS. Its objectives are to set out a conceptual model linking NICE decision making based on explicit thresholds with the thresholds implicit in local decision making and to gauge the feasibility of (a) identifying those implicit local cost effectiveness thresholds and (b) using these to gauge the appropriateness of NICE's explicit threshold.
Original languageEnglish
Pages (from-to)239-45
Number of pages7
Issue number3
Publication statusPublished - Aug 2009


  • Cost-Benefit Analysis
  • Great Britain
  • Health Care Rationing
  • Hospitals, Public
  • Humans
  • Interviews as Topic
  • Quality-Adjusted Life Years
  • Questionnaires
  • State Medicine


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