Tuesday, 9 September 2014

Expanding role for NICE as HTA takes hold in the UK

The UK’s healthcare system is primarily public, but rising healthcare expenditure coupled with increasing demand is placing a strain on the system. For example, according to the Office for National Statistics, expenditure on healthcare in the UK rose from £54.8 billion in 1997 to £142.8 billion in 2011. These trends, which are not unique to the UK, have led to the use of Health Technology Assessment (HTA) to determine what represents value for money at the national level for healthcare services.

Since its establishment as a Special Health Authority in 1999, the National Institute for Health and Care Excellence (NICE) has become one of the leading organisations involved in HTA. Its stated role is to provide evidence-based guidance and advice for health, public health and social care practitioners. In effect, NICE aims to give independent advice about which treatments should be available on the NHS in England and Wales. The organisation often receives criticism in the media regarding its decisions and pharmaceutical industry representatives have been wary of NICE and believe that reforms of the UK’s approach to HTA are needed. However, NICE has also received several favourable reviews from independent agencies including the House of Commons Health Committee, the World Health Organization and independent academics.

In recent times, controversial NICE decisions regarding Alzheimers and cancer drugs have led to considerable negative media coverage and complaints from patients, but despite this, its role within healthcare is expanding. Reforms have seen the organisation expand its work into areas such as social care and it will be central to the introduction of value-based pricing (VBP), where the value of a drug will be based on an assessment of the evidence available and will directly influence how the manufacturer is reimbursed.

In order to respond to its critics, NICE has highlighted its commitment to transparency. On its website it features a number of opportunities for stakeholders to contribute to the development of its recommendations. In addition, it runs scientific advice seminars, where manufacturers of drugs, medical devices and other technologies and other interested parties can learn more about NICE’s processes and what its assessors expect from submissions. The success of these seminars has led to requests from other organisations for partnerships with NICE in order to reach a wider audience of developers, particularly at international events. Companies can also book a site visit where the NICE team can explain in greater detail the organisation’s scientific advice services.

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