The National Institute for Health and Care Excellence has begun a formal consultation on proposed changes to the way it makes recommendations on new medicines and other treatments for use in the NHS¹.

NICE assesses the clinical and cost effectiveness of new technologies to help ensure that patients have access to effective treatments and the NHS makes the best use of its resources.

The new proposals include ways to take into account more systematically and explicitly the severity of a disease, as well as the effect that diseases and conditions have on our capacity to engage in society.

The chief executive of NICE, Sir Andrew Dillon, explained:

“These proposed changes to the way we value new treatments will add further clarity to our recommendations and enable our independent advisory committees to explore more fully the potential these treatments have to improve outcomes for patients.”

The proposals outlined in the consultation have been developed taking into account the need to ensure consistency, predictability and transparency in the judgements made by our independent Appraisal Committees when they consider the clinical and cost effectiveness of health technologies.

The consultation makes clear that the Appraisal Committees will not use the age of people with particular conditions to make the difference between whether a new treatments is recommended or not. Similarly they will not use gender or any of the other ‘protected' characteristics under equalities legislation. In October 2012, the Government implemented a ban on age discrimination in the NHS.

NICE wants to hear from anyone interested in the appraisal of health technologies including patients, carers, patient groups, clinicians, academics, economists, industry and members of the public to help ensure that NICE's processes are robust and fair.

The consultation will begin on 27 March and last 3 months, ending on 20 June. The NICE Board will then consider the final changes to the Methods Guide and they will be introduced in the Autumn. Any topics referred to NICE after approval of the final new methods will be subject to the new arrangements.

Ends

For more information call the NICE press office on 0845 003 7782 or out of hours on 07775 583 813.

A copy of the consultation is available under embargo through the press office.

Notes to Editors

1. The consultation sets out proposals to amend our Guide to the Methods of Technology Appraisal 2013. The Guide is used by the independent committees of experts who appraise medicines and other technologies on behalf of NICE, for use in the NHS.

2. To evaluate the clinical and cost effectiveness of a technology, NICE measures its merit using a unit known as a quality adjusted life year or QALY. This is a useful way of comparing the costs and benefits of sometimes very different technologies in different conditions by looking at the gains to quality of life and life expectancy. This way of comparing technologies allows our independent advisory committees to understand the impact that introducing a new treatment will have on the ability of the NHS to maintain the services it already provides.

3. Burden of illness is the loss (or shortfall) in quality and length of life, measured in QALYs (quality adjusted life years), as a consequence of having a disease or condition, when compared with the QALYs that people would expect to have over the rest of their lives without the condition. The burden of illness is measured from the point at which the new treatment is introduced. This shortfall in QALYs will be considered relative to what people could expect without the condition at the time of treatment and is therefore called the ‘proportional QALY shortfall'. The proposal for incorporating burden of illness replaces our current approach (introduced in 2009) where our Appraisal Committees consider treatments to extend life (the ‘end of life treatments protocol').

4. We want to consider the wider impact of a disease on people's ability to be part of society. We refer to this as the ‘wider societal impact' and define it as the loss (or shortfall) in a person's capacity to engage with society as a result of living with the disease or condition, compared with their capacity to engage with society without the condition, measured in QALYs. We propose calculating wider societal impact by measuring the absolute shortfall in QALYs. Absolute shortfall is measured by subtracting the QALYs expected as a consequence of having the condition from the total QALYs expected for people with the same age and gender distribution without the condition.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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