NICE Citizens Council - how should NICE assess future costs and health benefits?
The tricky question of how NICE should assess future costs and health benefits will be discussed at the next Citizens Council meeting, taking place in London this week.
The Citizens Council of the National Institute for Health and Care Excellence (NICE), which provides public input into the Institute's work, holds its next meeting on 3 and 4 of November 2011. At this meeting the Citizens Council will be asked to consider the issue of discounting - the way in which health benefits are valued and calculated over a very long period of time. The Citizens Council will hear evidence from speakers covering all aspects of this topic, before taking part in thorough discussions to examine the issues in detail.
The Citizens Council consists of a diverse group of 30 individuals, reflecting the age, gender, socioeconomic status and ethnicity of the people of England and Wales. The council meets yearly to hear expert information on challenging topics and thoroughly discuss the issues raised. It is a formal committee of the Institute, helping to identify broad social values and how NICE might apply them in preparing its guidance. The Council's view on each topic discussed is captured in reports which provide advice to NICE and its independent committees; the Citizens Council does not produce any of NICE's guidance for the NHS.
Sir Michael Rawlins, Chair of NICE, said: "The tricky matter of how future health is valued over a long period of time, as well as determining the costs associated with treatments providing long-term health benefits, is exactly the sort of issue about which NICE wants the public's viewpoint. The Citizens Council makes an important contribution to the work of NICE by providing a snapshot of what the general public thinks about a range of healthcare issues. The views expressed by the Citizens Council can then be taken into account by NICE when developing its guidance processes.
"This issue of 'discounting' is important to NICE, because one of NICE's key functions is to assess whether the NHS should provide new treatmentsbased on the value for money which that particular treatment provides for the NHS based on its benefits for patients and cost. On rare occasions, NICE may assess drugs that provide a life-long health benefit to patients after only a short course of medication. This scenario can present particular issues for NICE committees because of the way that generally accepted economic methods determine how health benefits are valued and calculated over a very long period of time.
"Therefore on this occasion, the Citizens Council is asked to consider how NICE should assess future costs and health benefits. As part of this, the Council will be asked to consider issues such people's tendency to prefer to have the benefit of items - or in this case benefits to their health - as soon as possible, rather than waiting to receive that benefit at some point in the future.
"Also if the main cost of a treatment occurs in the future, then we need to calculate how much the equivalent value is today. To do this, the cost needs to be adjusted by a certain amount which is called the discount rate. The Citizens Council will be asked to consider how different views on valuing future health benefits and costs translate into different discount rates, and how this affects conclusions on whether a new treatment could be considered cost effective or not.
"We are keen to hear from the Citizens Council on precisely this kind of difficult social values issue, as it will help provide guidance to our independent advisory committees when they are required to make recommendations involving this approach."
A report on the Council's views will be available on the NICE website for public comment, before the Council submits a report to the Board of NICE setting out its findings.
Notes to Editors
1. A limited number of places will be available to attend the presentations on Thursday 3 November and Friday 4 November. Journalists interested in attending should contact Tonya Gillis in the NICE Press Office at firstname.lastname@example.org or 0845 003 7782 for further information. Other potential attendees should contact Lucy Connor (email@example.com) to request a place. All potential attendees must register in advance, by 2pm on Wednesday 2 November.
2. Since it was set up, the Citizens Council has provided valuable input on a range of issues including: incentives to promote individual behaviour change, patient safety, harm reduction in smoking, and ‘only in research' recommendations. Previous reports are available at http://www.nice.org.uk/aboutnice/howwework/citizenscouncil/reports.jsp .
3. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health
4. NICE produces guidance in three areas of health:
- public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
- health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
- clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.
5. NICE produces standards for patient care:
- quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
- Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients
6. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.
This page was last updated: 03 November 2011