The UK’s health watchdog has announced a new proposal that will see some life-extending drugs being made available to patients, when in the past they would not have been. The independent announcement by the National Institute for Health and Clinical Excellence coincides with Professor Mike Richards top-up review and comes almost a fortnight after NHS officials called on MPs for a debate on the value of life-extending medicines.
The NICE proposal will plan to see changes to its technology appraisal process whereby NICE will provide additional evidence to its Appraisal Committees for drugs that may have a clinical benefit but are not normally deemed cost-effective. “The Institute is aware that patients, and the public, place considerable value on treatments that offer the possibility of extending life when we are close to death,” said Andrew Dillon, NICE Chief Executive. “We believe that we should reflect that view when we are asked to make recommendations on the use of medicines that are designed to extend life, at the end of life. The new advice we are giving to our Appraisal Committees will help them to take account of this and will better enable them to decide when to recommend the use of life extending treatments.”
To be considered under this supplementary advice, a medicine would need to: be licensed for treating a patient population of less than 7,000 new patients each year; be indicated for the treatment of patients with a terminal illness who are not expected to live for more than 24 months; have sufficient evidence to indicate that it offers a substantial average extension to life compared to current treatment; have been accessed by NICE as having an incremental cost-effectiveness ratio in excess of the upper end on the range (£30,000) normally considered by NICE’s Appraisal Committees to represent a cost effective use of NHS resources; and that no alternative treatment with comparable benefits should be available through the NHS.In addition, and subject to agreement with the Department of Health, medicines recommended for use on the basis of the above criteria would be subject to an appropriately designed programme of evidence development to ensure that the anticipated survival gains are evident when used in routine practice. Dillon said the Institute had been considering for some time how to approach decisions on life extending medicines, particularly those that were expensive and for rare conditions, and “we decided to make out contribution to finding a solution to the issue of co-payments” in conjunction with the top-up review. The exact specifics of the proposal are still being worked out and are the subject of a five-week public consultation.The Institute plans to apply the supplementary advice at the next Appraisal Committee meeting in January.
Isnt this fantastic news?
Although I dont understand why we have to wait until Janurary - why cant they apply this advice right now?