NICE Submission Workflow
Source:vignettes/v06_nice_submission_workflow.Rmd
v06_nice_submission_workflow.RmdNICE 2025 requirements
NICE (2025) Methods Support Document (PMG36) on health inequalities requires manufacturers to submit DCEA as supplementary evidence when:
- The intervention targets a condition with documented SES gradients.
- The ICER is above £20,000/QALY and equity may affect the decision.
- The committee requests equity evidence.
Step-by-step NICE workflow
1. Determine method
Use aggregate DCEA unless subgroup-specific evidence is available.
# Check whether disease has SES gradient
# Use disease_icd to auto-lookup HES utilisation
result <- run_aggregate_dcea(
icer = 28000,
inc_qaly = 0.45,
inc_cost = 12600,
population_size = 12000,
disease_icd = "C34",
wtp = 20000,
opportunity_cost_threshold = 13000
)2. Sensitivity analysis
NICE expects sensitivity over key parameters, especially η.
sa <- run_dcea_sensitivity(result, params_to_vary = c("eta", "wtp", "occ_threshold"))
sa$eta_profile
#> # A tibble: 11 × 5
#> eta equity_weight_q1 equity_weight_q5 equity_weighted_nhb delta_ede
#> <int> <dbl> <dbl> <dbl> <dbl>
#> 1 0 1 1 -1246. -0.104
#> 2 1 1.14 0.886 -1265. -0.106
#> 3 2 1.28 0.779 -1284. -0.108
#> 4 3 1.43 0.680 -1303. -0.110
#> 5 4 1.59 0.589 -1322. -0.112
#> 6 5 1.75 0.506 -1340. -0.114
#> 7 6 1.92 0.432 -1358. -0.116
#> 8 7 2.09 0.366 -1374. -0.118
#> 9 8 2.25 0.308 -1390. -0.119
#> 10 9 2.42 0.258 -1405. -0.121
#> 11 10 2.58 0.215 -1419. -0.1223. Generate submission table
tbl <- generate_nice_table(result, format = "tibble")
knitr::kable(tbl, caption = "DCEA Summary Table (NICE format)")| Equity subgroup | Baseline HALE (years) | Post-intervention HALE (years) | Change in HALE (years) | Net Health Benefit (QALYs) | Population share |
|---|---|---|---|---|---|
| Q1 (most deprived) | 52.1 | 51.97 | -0.1298 | -1557.69 | 0 |
| Q2 | 56.3 | 56.18 | -0.1168 | -1401.92 | 0 |
| Q3 | 59.8 | 59.70 | -0.1038 | -1246.15 | 0 |
| Q4 | 63.2 | 63.11 | -0.0909 | -1090.38 | 0 |
| Q5 (least deprived) | 66.8 | 66.72 | -0.0779 | -934.62 | 0 |
| Total / Summary | NA | NA | NA | -6230.77 | 1.000 |
4. Export to Excel
export_dcea_excel(result, "dcea_submission.xlsx")