We consulted on changes to the arrangements for evaluating and funding drugs and other health technologies appraised through NICE’s Technology Appraisal (TA) and Highly Specialised Technologies (HST) programmes. The consulation ran from 13 October 2016 to 13 January 2017.
Thank you to everyone who commented. You can view the analysis of responses to the consultation below.
NICE and NHS England intend to work together more closely to better manage access to new drugs and medical technologies (devices and diagnostics) by simplifying and speeding up some appraisals, and by making the arrangements for funding others more clear.
The proposed changes will benefit patients by providing access to the most effective and cost-effective new treatments more quickly and will help the life sciences industry by increasing the opportunities for companies to help manage the introduction of their new technologies into the NHS.
The NHS is committed to providing timely access to new treatments, but introducing new technologies in a way that is both good for UK business and, at the same time, optimises the financial sustainability of the NHS can be challenging.
This consultation sets out a number of ways in which NICE and NHS England can provide an environment that encourages the life sciences industry and the NHS to work together in the best interests of patients. By facilitating collaboration and providing opportunities for early dialogue between innovators and the NHS, and by speeding up appraisal and adoption processes, NICE and NHS England can enable the development of arrangements that deliver the right outcomes for both patients and the life sciences industry.
Summary of proposals
- Introduce a ‘fast track’ NICE technology appraisal process for the most promising new technologies, which fall below an incremental cost-effectiveness ratio of £10,000 per QALY (quality adjusted life year), to get these treatments to patients more quickly.
- Operate a ‘budget impact threshold’ of £20 million, set by NHS England, to signal the need for a dialogue with companies to agree special arrangements to better manage the introduction of new technologies recommended by NICE. This would apply to a small number of technologies that, once determined as cost effective by NICE, would have a significant impact on the NHS budget.
- Vary the timescale for the funding requirement when the budget impact threshold is reached or exceeded, and there is therefore a compelling case that the introduction of the new technology would risk disruption to the funding of other services.
- Automatically fund, from routine commissioning budgets, treatments for very rare conditions (highly specialised technologies) up to £100,000 per QALY (5 times greater than the lower end of NICE’s standard threshold range), and provide the opportunity for treatments above this range to be considered through NHS England’s process for prioritising other highly specialised technologies.