Resource summary report
Resource impact summary report
This summary report is based on the NICE assumptions used in the resource impact template. Users can amend the 'Inputs and eligible population' and 'Unit costs' worksheets in the template to reflect local data and assumptions.
Recommendations
NICE has recommended that Online Remote Behavioural Intervention for Tics (ORBIT; Mindtech) can be used with standard care in the NHS during the evidence generation period as an option to treat chronic tic disorders and Tourette syndrome in children and young people 9 to 17 years. It can only be used if the evidence outlined in the evidence generation plan for ORBIT is being generated.
The use of ORBIT will incur additional costs that would vary depending on current local practice. Any additional costs should be assessed at a local level.
Eligible population
Around 2.5% (157,300) of children and young people aged 9 to 17 years old are estimated to have chronic tic disorders and Tourette syndrome in England. The 2.5% applies to all children under 18 years and has been used as a proxy for the population of children and young people 9 to 17 years covered by the guidance.
It is not known how many of these are in contact with specialist services or referred to specialist services. Users should enter a value locally reflecting local practice in the resource impact template. Many people are not getting the diagnosis and treatment options they need because of variations in access and availability of services (Marino et al. 2023). Of these, it is assumed that 20% will be eligible for treatment with ORBIT based on clinical expert opinion. This can be amended and profiled across years locally in the resource impact template.
| Description | Number |
|---|---|
|
Children aged 9 to 17 years (n) |
6,291,756 |
|
Percentage with chronic tic disorders and Tourette syndrome (%) |
2.5 |
|
Children with chronic tic disorders and Tourette syndrome (n) |
157,294 |
The data in table 1 is based on (Marino et al. 2023 and Knight et al. 2012).
Treatment options for the eligible population
Current practice for the treatment of chronic tic disorders and Tourette syndrome varies across the country but includes:
-
psychoeducation
-
behavioural therapy and
-
pharmacological therapy.
The NICE guideline on suspected neurological conditions: recognition and referral contains recommendations on tic disorders.
Because of variation in practice across the NHS, it is not known how many people currently have standard care treatments.
Financial resource impact (cash items)
Implementation of Online Remote Behavioural Intervention for Tics (ORBIT) will incur additional costs because it will be used with standard care. Additional costs will vary depending on local current practice.
The pricing details for ORBIT are not yet available.
Capacity impact
The digital therapy may contribute to the effective management of waiting lists. If children can be treated through the guided self-help program, then healthcare professionals may be able to prioritise assessment for people on waiting lists differently. They may therefore be able to shorten the wait for children with severe needs who may need additional support to that available within a guided self-help intervention.
Benefits
Digital therapy may:
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help improve access to services and offer another treatment option
-
allow flexibility in access to treatments for people who prefer a digital therapy rather than face-to-face therapy
-
help manage waiting lists and referrals to specialist services because of increased treatment options
-
enable services to triage more effectively and provide more direct healthcare-professional contact for severe presentations using the ORBIT intervention, which includes several sessions of psychoeducation that can be delivered through guided self-help.
Key information
Table 2 Key information| Specialty area |
Neurology |
|---|---|
| Disease area |
Tic disorders and Tourette syndrome |
| Programme budget category |
PBC05D: Child and Adolescent Mental Health Disorders |
| Commissioners |
Integrated care boards |
| Providers |
Primary care, Community health care |
| Pathway position |
Treatment/management |
About this resource impact summary report
This resource impact summary report accompanies the NICE guidance on and Digital therapy for chronic tic disorders and Tourette syndrome should be read with it. See terms and conditions on the NICE website.
ISBN: 978-1-4731-7007-0
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