Chronic Heart Failure Methods NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 If the committee recommended an intervention that was estimated to cost more than 20,000 per QALY gained, or did not recommend one that was estimated to cost less than 20,000 per QALY gained, the reasons for this decision are discussed explicitly in the Recommendations and link to evidence section of the relevant chapter, with reference to issues regarding the plausibility of the estimate or to the factors set out in Social value judgements: principles for the development of NICE When QALYs or life years gained are not used in the analysis, results are difficult to interpret unless one strategy dominates the others with respect to every relevant health outcome and cost. 4.4.4 In the absence of health economic evidence When no relevant published health economic studies were found, and a new analysis was not prioritised, the committee made a qualitative judgement about cost effectiveness by considering expected differences in resource use between options and relevant UK NHS unit costs, alongside the results of the review of clinical effectiveness evidence. The UK NHS costs reported in the guideline are those that were presented to the committee and were correct at the time recommendations were drafted. They may have changed subsequently before the time of publication. However, we have no reason to believe they have changed substantially. 4.5 Developing recommendations Over the course of the guideline development process, the committee was presented with: Evidence tables of the clinical and health economic evidence reviewed from the literature. All evidence tables are in appendices F and G. Summaries of clinical and health economic evidence and quality (as presented in chapters 5-10). Forest plots and summary ROC curves (appendix E). 