NICE guidance has a significant impact on the NHS
Use of drugs recommended by NICE has, in many cases, exceeded our predictions, according to a report published by the Information Centre for Health and Social Care in September. It shows that our guidance is having a significant impact on the treatment and care patients receive from the NHS.
‘Use of NICE appraised medicines in the NHS in England - experimental statistics' focused on the use of 26 drugs recommended by NICE in 13 of our technology appraisals. It compares the predictions we made when developing the guidance with actual uptake.
Conditions covered by these appraisals range from Alzheimer's disease, asthma, multiple sclerosis and breast cancer to insomnia and smoking cessation.
Out of the 12 appraisals where a comparison could be made, actual use of the recommended drugs was higher than predicted for seven, and lower for five of them.
This does not necessarily mean there has been either ‘under' or ‘over' prescribing. By making predictions about the likely cost impact we are helping local NHS commissioners when they set their budgets. However, the costing templates we provide do need to be amended to reflect local circumstances.
There is bound to be uncertainty, not just in our predictions, but in the conversion from predicted number of patients into actual prescribed doses. For example, some clinicians may prescribe a drug for a longer period than that recommended by NICE.
Regional variations could also be accounted for by epidemiological differences or differences in prescribing practice (for example, some clinicians may recommend using smoking support groups before prescribing drug treatments).
NICE's technology appraisals assess the clinical and cost effectiveness of new and existing drugs and treatments and advise on how they could be used by the NHS.
As part of the Pharmaceutical Price Regulation Scheme (PPRS) agreement, which came into effect on 1 January 2009, the Department of Health (DH) and the Association of the British Pharmaceutical Industry agreed that the DH would review uptake of selected medicines recommended by NICE.
PPRS aims to ensure the NHS has access to good quality, branded medicines at reasonable prices.
NICE was the first national body to systematically assess the likely impact its recommendations would have on local budgets and is continually refining how this is achieved. The report will feed into that process.
For the future, NICE plans to highlight instances where our guidance is saving the NHS money. One potential example is our clinical guideline on long-acting reversible contraception (LARC) which, if implemented, we estimate will save the NHS around £100m net each year.
The NHS Information Centre report is the first of a planned series of annual bulletins on the uptake of drugs recommended by NICE. You can find the full report here.
Issued: 26 October 2009
This page was last updated: 10 May 2010