New thinking on end-of-life medicines
In January 2009 NICE introduced changes to its technology appraisal process to make clearer the circumstances in which it may be appropriate to recommend the use of life-extending treatments licensed for terminal illnesses affecting small numbers of patients. These treatments, following appraisal, will be ones that the committees decide offer demonstrable survival benefits over current NHS practice.
This means that treatments that may have been previously ruled out as not sufficiently cost effective for routine use in the NHS might now be recommended for use. Treatments that are licensed for small patient populations and that will increase a short life expectation by at least 3 months will be considered. The change followed a public consultation during which NICE received 1100 responses.
Andrew Dillon, NICE Chief Executive, said: "The existing guidance to our Appraisal Committees recognises that there may be circumstances in which they might consider it appropriate to accept higher incremental cost-effectiveness ratios for life-extending treatments at the end of life.
"This reflects the views of NICE's Citizens Council and previous decisions have taken a number of particular circumstances into account. NICE is also conscious of its responsibility to support the development of novel treatments for smaller patient groups that provide innovative benefits over and above existing NHS care. NICE is therefore asking its Appraisal Committees to consider the impact of giving greater weight to extensions to life when people have a short remaining life span."
The first technology to be approved using this new criteria was sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma.
This page was last updated: 10 November 2010
