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How to make a good economics submission to SMC. Dr Andrew Walker. How NDC reviewers make their decisions What are the common problems to avoid in your submissions Potential ways to improve submission quality. Reviewing the economics in a submission.
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How to make a good economics submission to SMC Dr Andrew Walker
How NDC reviewers make their decisions • What are the common problems to avoid in your submissions • Potential ways to improve submission quality
Reviewing the economics in a submission • Checklist used to structure critical appraisal exercise • No limit on the number of ‘accepted for use’ decisions we make
Things we look for at NDC stage the deal-breakers • Does it have any economics? • Is there an obvious ‘fatal flaw’? • Is the ICER very high?
If no deal-breakers, what next? • If no ‘fatal flaw’ or very high ICER, what other problems are there? • How material are they? • Does sensitivity analysis help with any optimism bias?
Most common problems 1 • Over-optimistic assumptions • Issues with comparator • Clinical data weaknesses
Most common problems 2 • Issues with time horizon • Issues with indirect comparison • Generalisability of data inputs
Most common problems 3 • Lack of transparency • Errors • Failure to consider other possible role for medicine
Potential ways to improve quality? • Use more sensitivity analysis • but might take time • what if ICER already high? • company may chose not to provide analysis to address issue raised in draft DAD
Another potential solution? • SMC to provide more education to companies • Is there a need to help small companies? • At what level would the education be most effective?