What is cost effectiveness?

Costs

• NHS costs of the health intervention minus the NHS costs saved by the intervention

• Measured in £

Benefits

• Health benefits gained by preventing /treating the health problem

• Measured in quality of life years (QALYs)

• 1 QALY = 1 year at full health

• There are infinite demands on our NHS, but a limited pot of money• Cost effectiveness analysis is a tool to help decide which interventions offer the best value for money and should be made available on the NHS• In theory, interventions that are low cost, but have high benefits in terms of health gains take priority over those with high costs and low health gains

*NHS costs also include personal social services costs

Years of life saved

PLUS

Quality of life saved from preventing disease

• The NHS is currently valued at £20,000/QALY

• All new interventions should cost £20,000/QALY or less, otherwise the NHS becomes less efficient (we end up spending more money on a given amount of health)

Vaccination costs

MINUS

Cost savings to NHS and social services from preventing disease

The cost effectiveness threshold

The cost effectiveness assessment of Bexsero on which the JCVI based their interim statement gave a result which was considerably higher than £20,000 so they could not recommend the vaccine for routine use

Was the JCVI interim opinion correct?

• A cost effectiveness model is a simplification of reality

• The answer you get depends on the parameters that you feed into the model

• MRF argued that the parameters underpinning the burden of meningococcal disease were undervalued