The NICE’s Citizens Council, a lay body of around 30 members which provides public input into the Institute's work, has published the final report on its discussions about how NICE should assess future (as opposed to immediate) costs and health benefits. The Council’s views on the issue of discounting – the way in which health benefits are valued and calculated over a very long period of time – will be used to guide the methods used by NICE's independent advisory committees. Comments received from the public have been factored into the report, which has been formally accepted by the NICE Board.
The Council considered how different views on valuing future health benefits and costs translate into different discount rates. Discounting has the effect of reducing the impact of longer-term benefits, which obviously has implications when NICE’s committees are assessing the cost effectiveness of an intervention which is costly in the short-term but provides a much longer-term benefit.
By a majority, the Council concluded that discounting is a legitimate aspect of the calculation of future costs and health benefits but advised that, where (for example) costs are upfront but the benefits accrue over a long period of time (eg, a curative drug for a childhood condition; some preventative public health measures), the Institute should depart from its current policy of applying a 3.5 per cent discount.