How to make a good economics submission to SMC

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How to make a good economics submission to SMC

• Dr Andrew Walker

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• How NDC reviewers make their decisions
• What are the common problems to avoid in your
  submissions
• Potential ways to improve submission quality

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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

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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?

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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?

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Most common problems 1

• Over-optimistic assumptions
• Issues with comparator
• Clinical data weaknesses

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Most common problems 2

• Issues with time horizon
• Issues with indirect comparison
• Generalisability of data inputs

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Most common problems 3

• Lack of transparency
• Errors
• Failure to consider other possible role for
  medicine

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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

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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?